External cephalic version at 38 weeks' gestation at a specialized German single center.

<h4>Introduction</h4>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.<h4>Objective</h4>This study aimed to...

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Autores principales:	Ann-Sophie Zielbauer, Frank Louwen, Lukas Jennewein
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a91f28cf179d4fb78d4eff16c00740a2
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spelling	oai:doaj.org-article:a91f28cf179d4fb78d4eff16c00740a22021-12-02T20:17:30ZExternal cephalic version at 38 weeks' gestation at a specialized German single center.1932-620310.1371/journal.pone.0252702https://doaj.org/article/a91f28cf179d4fb78d4eff16c00740a22021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252702https://doaj.org/toc/1932-6203<h4>Introduction</h4>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.<h4>Objective</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.Ann-Sophie ZielbauerFrank LouwenLukas JenneweinPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0252702 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ann-Sophie Zielbauer Frank Louwen Lukas Jennewein External cephalic version at 38 weeks' gestation at a specialized German single center.
description	<h4>Introduction</h4>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.<h4>Objective</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.
format	article
author	Ann-Sophie Zielbauer Frank Louwen Lukas Jennewein
author_facet	Ann-Sophie Zielbauer Frank Louwen Lukas Jennewein
author_sort	Ann-Sophie Zielbauer
title	External cephalic version at 38 weeks' gestation at a specialized German single center.
title_short	External cephalic version at 38 weeks' gestation at a specialized German single center.
title_full	External cephalic version at 38 weeks' gestation at a specialized German single center.
title_fullStr	External cephalic version at 38 weeks' gestation at a specialized German single center.
title_full_unstemmed	External cephalic version at 38 weeks' gestation at a specialized German single center.
title_sort	external cephalic version at 38 weeks' gestation at a specialized german single center.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/a91f28cf179d4fb78d4eff16c00740a2
work_keys_str_mv	AT annsophiezielbauer externalcephalicversionat38weeksgestationataspecializedgermansinglecenter AT franklouwen externalcephalicversionat38weeksgestationataspecializedgermansinglecenter AT lukasjennewein externalcephalicversionat38weeksgestationataspecializedgermansinglecenter
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External cephalic version at 38 weeks' gestation at a specialized German single center.

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