Impact of parity on obstetric and neonatal outcome of external cephalic version

This study sought to investigate the impact of parity on the outcome of external cephalic version (ECV) over a 3-year period. In the study, 163 women with singleton uncomplicated breech pregnancy at term were offered ECV and 103 (63%) underwent the procedure. In 42 women, ECV was successful and 74% had a vaginal vertex delivery; whereas 61 women had a failed ECV and none had a vaginal vertex delivery. The probability of vaginal vertex delivery after ECV increased five-fold in nulliparous women (OR 5.2, 95% CI 1-42.8) and four-fold (OR 3.8, 95% CI 1.3-11.5) in multiparous women. After successful ECV, 50% of nulliparous women and 88.5% of multiparous women had a vaginal vertex delivery (p = 0.006). Neonatal outcome was favourable in all patients. We conclude that parity has little impact on efficacy of ECV, but significantly influences the overall chance of vaginal vertex delivery in women with an uncomplicated breech presentation at term.