The Early External Cephalic Version (ECV) 2 Trial
Author Information
Author(s): EK Hutton, ME Hannah, SJ Ross, MF Delisle, GD Carson, R Windrim, A Ohlsson, AR Willan, A Gafni, G Sylvestre, R Natale, Y Barrett, JK Pollard, MS Dunn, P Turtle
Primary Institution: McMaster University Faculty of Health Sciences
Hypothesis
Does early ECV (at 34–35 weeks of gestation) versus delayed ECV (not before 37 weeks of gestation) decrease or increase the likelihood of caesarean section?
Conclusion
Early ECV increases the likelihood of cephalic presentation at birth but does not reduce the rate of caesarean section and may increase the rate of preterm birth.
Supporting Evidence
- Fewer fetuses were in a non-cephalic presentation at birth in the early ECV group compared to the delayed ECV group.
- The rate of caesarean section was not significantly different between the two groups.
- The rate of preterm birth was not significantly different between the two groups.
- Women in the early ECV group reported less pain during the procedure.
Takeaway
This study looked at whether doing a procedure to turn breech babies earlier in pregnancy helps them be born head-first. It found that while it does help with that, it doesn't lower the chances of needing a C-section and might even lead to earlier births.
Methodology
An unblinded multicentred randomised controlled trial with 1543 women from 68 centres in 21 countries, comparing early ECV (34–35 weeks) to delayed ECV (37 weeks or more).
Potential Biases
Potential bias due to the non-blinding of participants and clinicians.
Limitations
The study may not have enough power to detect a real difference in caesarean section rates due to a smaller than anticipated difference in rates.
Participant Demographics
Women with a singleton breech fetus at gestational ages of 330/7 to 356/7 weeks.
Statistical Information
P-Value
0.002
Confidence Interval
0.75, 0.94
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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