Mode of childbirth and neonatal outcome after external cephalic version: A prospective cohort study |
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| Affiliation: | 1. University of Amsterdam, Academic Medical Center, Department of Obstetrics & Gynaecology, Amsterdam, The Netherlands;2. University of Amsterdam, Academic Medical Centre, Clinical Research Unit, The Netherlands;3. VU medical center (VUmc), the Netherlands University of Amsterdam, Department of Obstetrics & Gynaecology, Amsterdam, The Netherlands;4. Rode Kruis Hospital, Beverwijk, The Netherlands;5. The Robinson Institute| School of Paediatrics and Reproductive Health, University of Adelaide, 5000 SA, Australia;1. Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK;2. Health Poverty Action Sierra Leone, 25 Barracks Road, Murray Town, Freetown, Sierra Leone;1. College of Nursing and Institute of Nursing Science, Ajou University, 164 Worldcup-ro, Yeongtong-gu, Suwon, Republic of Korea;2. College of Nursing, Ajou University, 164 Worldcup-ro, Yeongtong-gu, Suwon, Republic of Korea;3. 360 Huntington Avenue, School of Nursing, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA;1. Department of Women''s and Children''s Health, Uppsala University, Sweden;2. Department of Women''s and Children''s Health, Karolinska Institutet, Sweden;3. Indian Institute of Public Health, Gandhinagar, Gujarat, India;4. Department of Public Health, Karolinska Institutet, Sweden;1. The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou 215006, China;2. School of Nursing, Soochow University, No.1 Shizi Street, Suzhou 215006, China;3. Center for Transitional Sciences, Children''s National Health System, 111 Michigan Ave., N.W., Washington, DC 20010, USA;4. School of Medicine and Health Sciences, George Washington University, 2121 I Street, N.W., Washington, DC 20052, USA;5. Department of Sociology and Anthropology, Purdue University, 101 N. Grant St., West Lafayette, IN 47907, USA;6. Epidemiology and Biostatistics Department, George Washington University, 2121 I Street, N.W., Washington, DC 20052, USA |
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| Abstract: | Objectiveto assess the mode of childbirth and adverse neonatal outcomes in women with a breech presentation with or without an external cephalic version attempt, and to compare the mode of childbirth among women with successful ECV to women with a spontaneous cephalic presentation.Designprospective matched cohort study.Setting25 clusters (hospitals and its referring midwifery practices) in the Netherlands. Data of the Netherlands perinatal registry for the matched cohort.Participantssingleton pregnancies from January 2011 to August 2012 with a fetus in breech presentation and a childbirth from 36 weeks gestation onwards. Spontaneous cephalic presentations (selected from national registry 2009 and 2010) were matched in a 2:1 ratio to cephalic presentations after a successful version attempt. Matching criteria were maternal age, parity, gestational age at childbirth and fetal gender. Main outcomes were mode of childbirth and neonatal outcomes.Measurements and findingsof 1613 women eligible for external cephalic version, 1169 (72.5%) received an ECV attempt. The overall caesarean childbirth rate was significantly lower compared to women who did not receive a version attempt (57% versus 87%; RR 0.66 (0.62–0.70)). Women with a cephalic presentation after ECV compared to women with a spontaneous cephalic presentation had a decreased risk for instrumental vaginal childbirth (RR 0.52 (95% CI 0.29–0.94)) and an increased risk of overall caesarean childbirth (RR 1.7 (95%CI 1.2–2.5)).Key conclusionswomen who had a successful ECV are at increased risk for a caesarean childbirth but overall, ECV is an important tool to reduce the caesarean rate.Implication for practiceECV is an important tool to reduce the caesarean section rates. |
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| Keywords: | Breech presentation External cephalic version Mode of childbirth Neonatal outcome |
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