Management of labor after external cephalic version

Gabriel Levinhttp://orcid.org/https://orcid.org/0000-0003-1282-5379 1 , Amihai Rottenstreich 1 , Raanan Meyer 4 , Yishay Weill 2 , and Raphael N. Pollack 3
  • 1 Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
  • 2 Shaare Zedek Medical Center, Jerusalem, Israel
  • 3 Department of Obstetrics and Gynecology, Meuhedet HMO, Jerusalem, Israel
  • 4 Department of Obstetrics and Gynecology, Chaim Sheba, Afilliated to Tel-Aviv university, Ramat Gan, Israel
Gabriel LevinORCID iD: https://orcid.org/0000-0003-1282-5379, Amihai Rottenstreich
  • Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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, Raanan Meyer
  • Department of Obstetrics and Gynecology, Chaim Sheba, Ramat Gan, Afilliated to Tel-Aviv university, Tel-Aviv, Israel
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, Yishay Weill and Raphael N. Pollack

Abstract

Objectives

Current literature evaluating the role of induction of labor (IOL) following successful external cephalic version (ECV) attempt as compared to expectant management is limited. We aim to assess the risk of cesarean delivery in those undergoing immediate IOL following successful ECV as compared to those who were expectantly managed.

Methods

A retrospective cohort study of successful external cephalic versions. The study group included 57 women that were induced after procedure in the lack of maternal or fetal indications for induction of labor. These women were compared to 341 expectantly managed women. Maternal and fetal characteristics and outcomes were compared.

Results

Gestation age at delivery was higher among the expectant management group (401/7 vs. 384/7, median, p=0.002) as compared to the induction group. Cesarean delivery rates were similar between both groups (28 [8.2%] vs. 3 [5.3%], p=0.44). In a multivariate logistic regression analysis, only nulliparity was significantly associated with cesarean delivery (adjusted odds ratio 3.42, confidence interval 1.61–7.24, p=0.001). No correlation was found between the version-to-delivery interval and the risk for cesarean delivery.

Conclusions

Induction of labor after successful ECV was not shown to influence cesarean delivery rates. As immediate IOL may result in higher rate of early-term deliveries, and in light of the lack of clinical benefit, we advocate against elective IOL following successful ECV.

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