TY  - JOUR
A1  - Zielbauer, Ann-Sophie
A1  - Louwen, Frank
A1  - Jennewein, Lukas
T1  - External cephalic version at 38 weeks' gestation at a specialized german single center
T2  - PLOS ONE
N2  - Introduction: Cesarean section (CS) rates are increasing worldwide. One constant indication is the breech presentation at term. By offering external cephalic version (ECV) and vaginal breech delivery CS rates can be further reduced. Objective: This study aimed to analyze the ECV at 38 weeks of gestation with the associate uptake rate, predicting factors, success rate, and complications at a tertiary healthcare provider in Germany specializing in vaginal breech delivery. Methods: We conducted a prospective cohort study with retrospective data acquisition. All women with a singleton fetus in breech presentation presenting after 34 weeks of gestation for counseling between 2013 and 2017 were included. ECV impact factors were analyzed using logistic regression. Results: A total of 1,598 women presented for breech birth planning. ECV was performed on 353 patients. The overall success rate was 22.4%. A later week of gestation (odds ratio [OR] 1.69), an abundant amniotic fluid index (AFI score) (OR 5.74), fundal (OR 3.78) and anterior (OR 0.39) placental location, and an oblique lie (OR 9.08) were significantly associated with successful ECV in our population. No major complications were observed. The overall vaginal delivery rates could be increased to approximately 14% with ECV. Conclusion: The demand for alternative birth modes other than CS for breech birth is high in the area of Frankfurt, Germany. Our study offers evidence of the safety of ECV at 38 weeks. Centers with expertise in vaginal breech delivery and ECV can reduce CS-rates. To further establish vaginal breech delivery and ECV as alternate options, the required knowledge and skill should be implemented in the revised curricula.
KW  - Labor and delivery
KW  - Birth
KW  - Amniotic fluid
KW  - Pregnancy
KW  - Bradycardia
KW  - Preterm birth
KW  - Birth weight
KW  - Outpatients
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/64432
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-644328
SN  - 1932-6203
VL  - 16
IS  - 8, art. e0252702
SP  - 1
EP  - 16
PB  - PLOS
CY  - San Francisco, California, US
ER  -