THE INTRODUCTION OF EXTERNAL CEPHALIC VERSION AT TERM INTO ROUTINE CLINICAL-PRACTICE

External cephalic version (ECV) at greater-than-or-equal-to 37 weeks' gestation in suitable women with breech presentation was introduced in 1991 as a new management option at a University Teaching Hospital. Af ter 16 months, the policy was audited by analysing a prospectively col lected database of women offered ECV at term and by a retrospective re view of all breech deliveries during the same period. A total of 52 wo men had ECV attempted with an immediate success rate of 46%. Four othe r cases had undergone spontaneous version by the time they attended fo r ECV. Of the remaining 72 breech deliveries, 49 were known to be bree ch and were not offered ECV; 39 of these had no contraindication (28% failure to offer ECV). Of the breech presentations, 22 remained undiag nosed until labour (18% of total study group). These results suggest t hat ECV at term can be introduced safely and without difficulty, with a strict protocol. Whilst the overall impact of ECV at term in clinica l practice may be limited, if some vaginal breech deliveries and caesa rean sections can be avoided it is a useful addition to the antenatal management of individual women with breech presentation.