Five Predictors Of Successful Cephalic Version


RENO, NEV. — Five key factors predicted successful external cephalic version in a meta-analysis of 43 primary articles describing 8,089 cases, reported Dr. Marjolein Kok at the annual meeting of the Society for Gynecologic Investigation.

Predictors of success, in order, included the following:

▸ Uterine relaxation (odds ratio 19; 95% confidence interval 3.1–3.9).

▸ Nonengagement (OR 10; CI 6.6–15).

▸ Palpable fetal head (OR 9.4; CI 6.0–15).

▸ Multiparity (OR 3.5; CI 3.1–3.9).

▸ Maternal weight less than 65 kg (OR 1.8; CI 1.2–2.6).

Most studies included in the review were prospective cohort studies, said Dr. Kok in an interview at the meeting, where she presented her findings in poster form.

Studies were reviewed from Medline, Embase, Cochrane Library, and manual searching of bibliographies of known primary and review articles. Articles were included if they reported on both potential clinical prognosticators and external cephalic version success rates.

The final conclusions not only illuminated factors associated with success but offer a way to weigh the importance of each factor. For example, a relaxed uterus is 20 times more likely to predict success, making it a more important prognostic variable than maternal weight.

Dr. Kok, an obstetrician and registrar at the Academic Medical Center in Amsterdam, was assisted in the study by colleagues in the ob.gyn. department at her institution and by Dr. Ben Willem Mol of Maxima Medical Centre Veldhoven in the Netherlands.

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