Cephalic version by postural management for breech presentation.

BACKGROUND: It is possible that maternal posture may influence fetal position. Many postural techniques have been used to promote cephalic version.

OBJECTIVES: The objective of this review was to assess the effects of postural management of breech presentation on measures of pregnancy outcome.

SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth trials register and Controlled Trials Register were searched. Date of last search: March 2000.

SELECTION CRITERIA: Randomised and quasi-randomised trials comparing postural management with pelvic elevation for breech presentation, with a control group.

DATA COLLECTION AND ANALYSIS: Eligibility and trial quality were assessed by one or both reviewers.

MAIN RESULTS: Five studies involving a total of 392 women were included. No effect of postural management on the rate non-cephalic births was detected, either for the subgroup in which no external cephalic version was attempted, or for the group overall (relative risk 0.95, 95% confidence interval 0.81 to 1.11). No differences were detected for caesarean sections or Apgar scores below seven at one minute.

REVIEWER'S CONCLUSIONS: There is no evidence to support the use of postural management for breech presentation. The numbers of women studied to date remain relatively small.