The problem of pelvic presentation of the fetus remains relevant during the last decade due to the debatable questions about the method of delivery and methods of correction. External version is increasingly considered in foreign and Russian literature as an effective and sufficiently safe method of correction of the fetal position.
OBJECTIVE
To evaluate the efficacy and safety of external version at 36 weeks’ gestation and more, as well as the predictors of unsuccessful attempts to perform it.
MATERIAL AND METHODS
90 patients with singleton pregnancy were examined. The main group consisted of 30 pregnant women with pelvic presentation of the fetus in whom an attempt of external version was performed. The comparison group included 30 pregnant women with breech presentation and planned delivery through natural labor. The control group included 30 pregnant women with fetal head presentation with no complications and no premorbid background who were delivered through natural labor. The study included analysis of clinical and anamnestic data, general clinical examination, cardiotocography, ultrasound with Dopplerometry.
RESULTS
External version was effective in 86.7±7.4% of cases, in 6.7±1.6% of patients the attempt of rotation was unsuccessful, in 6.7±1.6% of pregnant women the fetus reversed after 2 days, therefore we classified these observations as unsuccessful attempts. We found that the only factor that influenced the effectiveness of external version was excessive body weight in women with unsuccessful attempts, the median BMI was 26.7 (min 22.0; max 34), in the group of women with successful attempts — Me 22.6 (min 17.5; max 27.9); p=0.035.
CONCLUSION
Thus, external version is effective and safe enough to reduce maternal traumatism and the frequency of operative delivery if the conditions and contraindications are adequately assessed.