The incidence of spontaneous version after failed external cephalic version.

OBJECTIVE: The objective of the study was to assess the rate of spontaneous version after failed external cephalic version (ECV) at term.

STUDY DESIGN: We prospectively collected data from all trials of ECV in our center between January 1997 and June 2005. Collected data included demographic and obstetric parameters.

RESULTS: Six hundred three ECV attempts were included in the study. Success rates were 72.3% and 46.1% for multiparas and nulliparas, respectively. Of the 226 failed attempts (8 were lost to follow-up), the rate of spontaneous version to vertex presentation before the onset of labor was 6.6%. Of all 15 spontaneous versions, 3 were in the nulliparous group (2.3%) and 12 in the multiparous group (12.5%).

CONCLUSION: The incidence of spontaneous version after failed ECV is small, at least in nulliparous women. We recommend that ECV attempts should be undertaken in a setting prepared for elective cesarean section in the event of ECV failure, if vaginal breech delivery is not considered an option, and preferably after 39 weeks to decrease neonatal morbidity from respiratory complications.