Probability of cesarean delivery after successful external cephalic version

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• 作者：Jorge Burgos^a ; ^{jburgoss@sego.es" class="auth_mail" title="E-mail the corresponding author} ; Marí ; a Iglesias^a ; José ; I. Pijoan^b ; ^c ; Leire Rodriguez^a ; Luis Ferná ; ndez-Llebrez^a ; Txantó ; n Martí ; nez-Astorquiza^a
• 关键词：Breech presentation ; Cesarean delivery ; Fetus ; Induced labor ; Labor ; Pregnancy ; Version
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：131
• 期：2
• 页码：192-195
• 全文大小：401 K

文摘

To identify factors associated with cesarean delivery following successful external cephalic version (ECV).

Methods

In a prospective study, data were obtained for ECV procedures performed at Cruces University Hospital, Spain, between March 2002 and June 2012. Women with a singleton pregnancy who had a successful, uncomplicated ECV and whose delivery was assisted at the study hospital, with the fetus in cephalic presentation, were included. A multivariate model of risk factors of cesarean delivery was developed.

Results

Among 627 women included, 92 (14.7%) delivered by cesarean. A cesarean was performed among 33 (8.5%) of 387 women with spontaneous labor versus 59 (24.6%) of 240 who were induced (P < 0.001). Multivariate analysis showed that higher BMI (P = 0.006), labor induction (P = 0.001), and prior cesarean (P < 0.001) were associated with cesarean. Time between ECV and delivery was inversely associated with probability of cesarean during the first 2 weeks. Thus, the probabilities of cesarean delivery on the first day were 0.53 (95% CI 0.35–0.71) and 0.34 (95% CI 0.18–0.51) following induced and spontaneous labor, respectively. On the seventh day, the probabilities were 0.23 (95% CI 0.15–0.32) and 0.12 (95% CI 0.07–0.18), respectively.

Conclusion

Following ECV, induction of labor, an interval of less than 2 weeks to delivery, BMI, and previous cesarean were associated with an increased risk of cesarean.