Il rivolgimento cefalico per manovre esterne come possibile trattamento della presentazione podalica del feto

Translated title of the contribution: External cephalic version as a possible treatment of breech presentation

M. Giusti, G. C. Bertolotti, R. E. Nappi, A. Fignon, C. Zara

Research output: Contribution to journalArticle

Abstract

Background. Breech presentation shows 3-4% incidence on every foetal presentation at the time of delivery and is more correlated than vertex presentation to a foetal risk of perinatal mortality (with a frequency from 2 to 5 times higher) and to foetal malformations, low weight at birth and prematurity. On the other hand, without a careful case selection, breech delivery has a higher risk of perinatal morbidity and mortality in comparison to cephalic presentation. It is estimated that perinatal mortality for breech presentation at term is about 4-5% for vaginal delivery and about 2-4% for caesarean section. In addition caesarean section has a higher maternal morbidity and a small but significant risk of perinatal mortality, therefore, external cephalic version (ECV) can be a good choice to increase physiological deliveries. The aim of the present study is to evaluate the real efficacy of this obstetric manoeuvre to decrease the frequency of breech presentation at delivery. Methods. The study group included 67 patients (age 29.5 ± 3.8) with foetal breech presentation at gestational age 35.8 ± 1.9 weeks, recruited at the Department of Obstetrics and Gynaecology of the Pavia University. Every patient underwent ECV. The same physician has performed every ECV attempt using the forward roll technique, with previous tocolysis in 50 cases (rithodrine vs isoxsuprine). The following variables have been taken into consideration : amount of amniotic fluid, gestational age, kind of tocolysis, placental location, foetal back position, parity, breech variety and foetal adnexial complication at birth. Results. ECV succeeded in 77.6% (n=52) and failed in 22.4% (n=15) of cases. No maternal or foetal complications, side effects and spontaneous breech version occurred and in 74.6% of cases (n=50) a vaginal delivery was performed. In 25.4% of cases (n=17) a caesarean section was performed (15 breech presentation, 1 foetal distress in labour and 1 cervical dystocia). Among variables examined related to successful ECV, it has been observed that the amount of amniotic fluid (χ2=15.33; p2=10.04; p2=3.98; p

Translated title of the contributionExternal cephalic version as a possible treatment of breech presentation
Original languageItalian
Pages (from-to)221-227
Number of pages7
JournalMinerva Ginecologica
Volume52
Issue number6
Publication statusPublished - Jun 2000

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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