THE IMPLEMENTATION OF EXTERNAL CEPHALIC VERSION AT TERM FOR SINGLETONBREECH PRESENTATION - HOW CAN WE FURTHER INCREASE ITS IMPACT

The overall incidence of breech presentation at delivery remained at 2 to 3% in a unit where external cephalic version (ECV) was the preferr ed treatment option for term singleton breech presentation. The object ive of this study was to investigate which factors accounted for this high residual incidence, so that the impact of ECV could be further in creased. All breech deliveries and ECVs over a 1-year period in a teac hing hospital are reviewed, The incidence of term singleton breech del ivery was 1.96% among 7,702 total deliveries, There were 115 patients counselled for ECV, of which 15.7% declined the offer and 4.1% went in to labour before their scheduled ECV. Among the 93 ECVs performed, 74 were successful and 56 delivered vaginally in cephalic presentation, E CV was not performed in 131 cases. The major reasons were patients' re fusal (13.7%), breech first diagnosed in labour or after rupture of me mbranes (44.3%), oligohydramnios or growth retardation (9.9%) and prev ious Caesarean section (8.4%), Only 5 patients were not counselled for ECV in the absence of contraindications. The practice of ECV reduced the overall Caesarean section rate by 0.65%, or 4.3% of the total numb er of Caesarean sections. In conclusion, ECV at term definitely reduce s the Caesarean section rate.