[External cephalic version in the management of breech presentation near to term (author's transl)].

Abstract

External cephalic version was tried in 58 from 146 cases of breech presentation after the 36th week of gestation and was successful in 55 per cent. The incidence of breech delivery was reduced from 5.3 to 4.2 per cent. With increasing weeks of gestation there was no rise in the failure rate. External version was more successful in multiparas than in primigravidas and in patients with high or low weight than in patients with normal weight and a thick muscular abdominal wall. The most frequent causes of failed versions were a thick muscular abdominal wall, extended legs and an already fixed breech in the pelvic inlet. 76 per cent of the deliveries took place within 10 days after the attempt of version. The weight of the newborns was except one over 2500 g, the average weight after successful version was 3250 g and after failed version 2930 g. Different severe fetal complications were seen after failed version but none when the attempt had been successful. On account of our own examinations and a critical analysis of the literature we came to the result that external cephalic version near to term should only be done after careful taken indication with a very precautioned technique, a thorough obstetrical examination, hospitalization and delivery shortly after.