External cephalic version effective for breech presentation at term

Clinical question: 
How effective is external cephalic version (ECV) for breech presentation at or near term on measures of pregnancy outcome?
Bottom line: 
ECV from 36 weeks reduces the chance of breech presentation at birth and caesarean section. There were no significant differences in the incidence of Apgar score ratings below 7 at 1 minute or 5 minutes, low umbilical artery pH levels, neonatal admission, perinatal death, nor time from enrolment to delivery. Large observational studies suggest complications are rare.
The numbers studied were too small to give an accurate assessment of the risks of ECV, though data from observational studies are reassuring. The trials reviewed did not provide information on women’s views on the use of ECV.
Management of breech presentation is controversial, particularly in regard to manipulation of the position of the foetus by ECV. ECV may reduce the number of breech presentations and caesarean sections, but there also have been reports of complications with the procedure.
Review CD#: 
June, 2011
Authored by: 
Brian R McAvoy