Reviving external cephalic version: a review of its efficacy, safety, and technical aspects

초록

Currently, the rate of cesarean sections being performed in Korea is approximately 40%, with Korea ranking4th among the Organization for Economic Co-operation and Development countries with respect to cesareandeliveries. Breech presentation at term is an important indication for cesarean section among other factors, includingmedicolegal concerns and pregnancies in women of advanced maternal age. Term breech presentation is associatedwith a higher fetal mortality rate than that associated with a cephalic presentation. Therefore, in Korea, most of thesewomen deliver by cesarean section to avoid the complications of vaginal breech delivery. However, cesarean sectionis itself associated with considerable obstetric morbidity and sometimes, mortality. External cephalic version (ECV) is auseful method to reduce the cesarean section rate in women with breech presentation and therefore to reduce theincidence of breech presentation at delivery. Studies have shown that routine use of ECV reduces the cesarean sectionrate by approximately two-thirds in term pregnancies with breech presentation. ECV is accepted as a safe, efficacious,and cost-effective method and is recommended by both the American College of Obstetricians and Gynecologistsand the Royal College of Obstetricians and Gynecologists in all pregnancies with term breech presentation, if notcontraindicated. In Korea, although most clinicians are aware of the option of ECV, their relative lack of experiencein performing the procedure and fear of complications render them hesitant to perform ECV. This review is aimed atguiding obstetricians by describing the efficacy, safety concerns, and technical aspects of this procedure.

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