Son M, et al. - Whether or not, with fetal malpresentation at term, perinatal morbidity and mortality differ between women who undergo an external cephalic version (ECV) attempt and those who do not and are expectantly managed was determined. Findings revealed no increased perinatal morbidity or mortality in association with an ECV attempt at term vs expectant management.

Methods

• Women with nonanomalous singleton gestations in nonvertex presentation delivering at a tertiary care institution from 2006 to 2016 were included in this retrospective cohort study.
• Researchers performed comparison of women undergoing an ECV attempt at 37 weeks of gestation or greater with those with nonvertex fetuses who did not undergo an ECV attempt and delivered at 37 weeks of gestation or greater.
• A composite of perinatal morbidity and mortality including stillbirth, neonatal death within 72 hours, Apgar score less than 5 at 5 minutes, umbilical artery pH less than 7.0, base deficit 12 mmol/L or greater, or neonatal therapeutic hypothermia were assessed as the primary outcome.
• Neonatal intensive care unit admission and neonatal anemia (hemoglobin value less than 13.5 g/dL) were included as secondary outcome measures.
• They performed bivariable and multivariable analyses.

Results

• Eligibility criteria was fulfilled by 4,117 women.
• Of these, 1,263 (30.7%) attempted ECV; 509 (40.3%) of these attempts resulted in successful versions.
• As per bivariable analyses, non-Hispanic white women and multiparous women and women with lower mean body mass indexes more frequently underwent attempted ECV.
• Women who did and who did not undergo attempted ECV showed no significant differences regarding the composite perinatal morbidity and mortality outcome (2.9% vs 2.5%, P=.46).
• Further, these women were similar in terms of the frequencies of neonatal intensive care unit admission (3.6% vs 3.3%, P=.53) and neonatal anemia (1.6% vs 1.2%, P=.36) .
• After adjustment for potential confounders, ECV attempt and composite perinatal morbidity and mortality outcome had no associations (adjusted odds ratio 1.02, 95% CI 0.66–1.60).