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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| Format: | Article |
| Language: | English |
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IMR Press
2024-12-01
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| 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. |
| format | Article |
| id | doaj-art-d9546bdcb6ef44b98f0c9651fc64b979 |
| institution | Kabale University |
| issn | 0390-6663 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| 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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