Preterm external cephalic version in an outpatient environment

Objective: Our purpose was to study the safety and efficacy of external cephalic version before term (37 weeks' gestation). Study design: We retrospectively reviewed 114 pregnancies in 110 women at 30 to 41 weeks' gestation who had a total of 133 attempts at external cephalic version. Results: Seventy-nine percent of the versions performed before the thirty-seventh week and 53% performed during or after the thirty-seventh week were successful. After adjustment for parity and body mass index, a version performed before the thirty-seventh week was 27 times more likely to be successful than if performed during or after the thirty-seventh week. Ninety-nine percent of the successful versions were delivered with a vertex presentation, and of these only 16% required cesarean delivery. Conclusion: External cephalic version is safe and successful if performed before 37 weeks' gestation, hence substantially reducing the rate of cesarean section among nonvertex presentations and reducing the risks associated with breech delivery.