Factors associated with intrapartum cesarean section after a successful external cephalic version

Abstract

Purpose

External cephalic version (ECV) is an effective procedure to reduce the breech presentation at term reducing the chances of cesarean section. However even after successful ECV reports suggests the risk of having a cesarean section is high. The study analyzes the mode of delivery after a successful ECV and to identify the factors associated with intrapartum cesarean delivery compared to those with spontaneous cephalic presentation.

Methods

This study was based on labor and delivery details, from the ECV registers, of 430 women who had successful ECV and they compared to those with spontaneous cephalic presentation. Primary outcome was delivery by cesarean section. Multiple logistic regression model was used to assess independent association of frisk factors associated with intrapartum cesarean section delivery by cesarean section and were presented as Odds Ratio (OR) and 95% confidence interval.

Results

Cesarean section rates were similar among those who had a successful ECV and those with spontaneous cephalic presentation (22.3% vs 20.1%, p = 0.298). Women who had a successful ECV (OR = 1.5; (95%CI 1.13–1.98), maternal age (OR1.06–1.03–1.09), and previous delivery by cesarean section (OR = 5.16 (95%CI; 1.88–14.16) were found to associated with intrapartum cesarean section after adjusting for other factors.

Conclusion

Women who had a successful ECV had an increased risk of intrapartum cesarean section compared those women with spontaneous cephalic presentation. Further research should be performed to identify more risk factors, which could optimize intra-partum care to reduce the risk of cesarean section for women after successful ECV.

Keywords:

• Breech presentation
• cesarean section
• external cephalic version

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

AK, KS SKG and PP conceived the study. All authors contributed to the design. PP, SKG and KA carried out the data collection and guarantees data integrity. AK performed statistical analyses. KA, SKG and PP reviewed the analysis and AK & PP wrote the first draft. All authors contributed to revising and finalization of the manuscript. AK (corresponding author) guarantees all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Data availability statement

The data underlying this article will be shared on reasonable request to the corresponding author.