Preoperative Predictors of Successful External Cephalic Version with Breech Presentation at Term: A Single-site Study

Background: To determine the factors associated with successful external cephalic version (ECV) of breech presentation at term in China. Methods: Pregnant patients who underwent ECV for a breech presentation at...

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Main Authors: Zhengrong Duan, Xiaoying Zhou, Aner Chen, Xiaobo He, Yinfen Wang
Format: Article
Language:English
Published: IMR Press 2024-12-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/51/12/10.31083/j.ceog5112279
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author Zhengrong Duan
Xiaoying Zhou
Aner Chen
Xiaobo He
Yinfen Wang
author_facet Zhengrong Duan
Xiaoying Zhou
Aner Chen
Xiaobo He
Yinfen Wang
author_sort Zhengrong Duan
collection DOAJ
description Background: To determine the factors associated with successful external cephalic version (ECV) of breech presentation at term in China. Methods: Pregnant patients who underwent ECV for a breech presentation at term from January 2020 to January 2023 were included in this retrospective observational study. From the candidate demographic and clinical factors a logistic regression model was employed to detect the predictors of ECV success. A receiver operating characteristic (ROC) curve was constructed to test the discriminative capacity of the final model. Results: The success rate of ECV in 207 pregnancies with a breech presentation at term was 68.6%. The rates of failed ECV after four to five attempts were 45/207 (21.7%), and suspected foetal hypoxia was present in 7 out of 207 (3.38%) babies. Three factors—an increased amniotic fluid index (AFI), the use of terbutaline and lower head circumference to femur length (HC/FL) ratio predicted the probability of a successful ECV. The area under the ROC curve (c-statistics) was 0.735 (95% confidence interval (CI) 0.649–0.800). Conclusions: An increased AFI, use of terbutaline, and a lower HC/FL ratio were all associated with successful ECV and can be used to estimate the chances of ECV success. ECV for breech presentation is a safe procedure with a reasonable success rate which increases the likelihood of a vaginal birth.
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spelling doaj-art-d9546bdcb6ef44b98f0c9651fc64b9792024-12-30T10:54:40ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632024-12-01511227910.31083/j.ceog5112279S0390-6663(24)02502-8Preoperative Predictors of Successful External Cephalic Version with Breech Presentation at Term: A Single-site StudyZhengrong Duan0Xiaoying Zhou1Aner Chen2Xiaobo He3Yinfen Wang4Maternal Health Care Department, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, 430015 Wuhan, Hubei, ChinaDepartment of Obstetrics, Yuyao Maternity and Child Health Care Hospital, Yuyao Second People’s Hospital, 315402 Ningbo, Zhejiang, ChinaDepartment of Obstetrics, Ningbo Women and Children’s Hospital, 315012 Ningbo, Zhejiang, ChinaDepartment of Obstetrics, Ningbo Women and Children’s Hospital, 315012 Ningbo, Zhejiang, ChinaDepartment of Obstetrics, Ningbo Women and Children’s Hospital, 315012 Ningbo, Zhejiang, ChinaBackground: To determine the factors associated with successful external cephalic version (ECV) of breech presentation at term in China. Methods: Pregnant patients who underwent ECV for a breech presentation at term from January 2020 to January 2023 were included in this retrospective observational study. From the candidate demographic and clinical factors a logistic regression model was employed to detect the predictors of ECV success. A receiver operating characteristic (ROC) curve was constructed to test the discriminative capacity of the final model. Results: The success rate of ECV in 207 pregnancies with a breech presentation at term was 68.6%. The rates of failed ECV after four to five attempts were 45/207 (21.7%), and suspected foetal hypoxia was present in 7 out of 207 (3.38%) babies. Three factors—an increased amniotic fluid index (AFI), the use of terbutaline and lower head circumference to femur length (HC/FL) ratio predicted the probability of a successful ECV. The area under the ROC curve (c-statistics) was 0.735 (95% confidence interval (CI) 0.649–0.800). Conclusions: An increased AFI, use of terbutaline, and a lower HC/FL ratio were all associated with successful ECV and can be used to estimate the chances of ECV success. ECV for breech presentation is a safe procedure with a reasonable success rate which increases the likelihood of a vaginal birth.https://www.imrpress.com/journal/CEOG/51/12/10.31083/j.ceog5112279external cephalic versionbreech presentationrisk factorsprediction model
spellingShingle Zhengrong Duan
Xiaoying Zhou
Aner Chen
Xiaobo He
Yinfen Wang
Preoperative Predictors of Successful External Cephalic Version with Breech Presentation at Term: A Single-site Study
Clinical and Experimental Obstetrics & Gynecology
external cephalic version
breech presentation
risk factors
prediction model
title Preoperative Predictors of Successful External Cephalic Version with Breech Presentation at Term: A Single-site Study
title_full Preoperative Predictors of Successful External Cephalic Version with Breech Presentation at Term: A Single-site Study
title_fullStr Preoperative Predictors of Successful External Cephalic Version with Breech Presentation at Term: A Single-site Study
title_full_unstemmed Preoperative Predictors of Successful External Cephalic Version with Breech Presentation at Term: A Single-site Study
title_short Preoperative Predictors of Successful External Cephalic Version with Breech Presentation at Term: A Single-site Study
title_sort preoperative predictors of successful external cephalic version with breech presentation at term a single site study
topic external cephalic version
breech presentation
risk factors
prediction model
url https://www.imrpress.com/journal/CEOG/51/12/10.31083/j.ceog5112279
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