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Clinical factors to predict the outcome of external cephalic version: a metaanalysis

      Objective

      The objective of the study was to systematically review the medical literature reporting on potential clinical prognosticators for the outcome of external cephalic version (ECV).

      Study Design

      Medline, EMBASE, and Cochrane Central Register of Controlled Trials were searched. Studies reporting on potential clinical prognosticators and ECV success rates that allowed construction of a 2 × 2 table were selected.

      Results

      We detected 53 primary articles reporting on 10,149 women. Multiparity (P ≥ 1.00; odds ratio [OR], 2.5; 95% confidence interval [CI], 2.3-2.8), nonengagement of the breech (OR, 9.4; 95% CI, 6.3-14), a relaxed uterus (OR, 18; 95% CI, 12-29), a palpable fetal head (OR, 6.3; 95% CI, 4.3-9.2), and maternal weight less than 65 kg (OR, 1.8; 95% CI, 1.2-2.6) were predictors for successful external cephalic version.

      Conclusion

      Success of an ECV attempt is associated with clinical factors. This should be taken into account in the counseling of women prior to an ECV attempt.

      Key words

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      Linked Article

      • Predicting the outcome of external cephalic version: Kok et al
        American Journal of Obstetrics & GynecologyVol. 199Issue 6
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          The article below summarizes a roundtable discussion of a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed: Kok M, Cnossen J, Gravendeel L, van der Post JA, Opmeer BC, Mol BW. Clinical factors to predict the outcome of external cephalic version: a metaanalysis. Am J Obstet Gynecol 2008;199:630.e1-630.e7. The full discussion appears at www.AJOG.org , pages e1-e5.
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