Identification of independent predictors of successful external cephalic version

Abstract

This study aimed to determine the success rate of external cephalic version (ECV) and identify independent predictors of successful ECV among women with a term singleton fetus in breech presentation. This retrospective multicenter study included 65 pregnant women who underwent ECV at 2 centers between January 2017 and January 2024. Participants were categorized into successful (n = 39) and failed (n = 26) ECV groups. Univariate analyses and multivariable logistic regression were used to identify independent predictors of successful ECV. The overall ECV success rate was 60.0% (39/65). Multivariable analysis showed that multiparity (odds ratio [OR], 5.54; 95% confidence interval [CI], 1.52–20.12; P = .009) and a nonanterior placental location (OR, 4.72; 95% CI, 1.31–17.03; P = .018) were independent positive predictors of ECV success. Maternal body mass index showed a borderline inverse association with success (OR, 0.84; 95% CI, 0.70–1.00; P = .053). No severe maternal or neonatal complications occurred. Vaginal delivery was achieved by 89.7% of women in the successful ECV group and none in the failed ECV group ( P < .001). Multi parity and a nonanterior placental location were associated with greater odds of successful ECV. Pre procedural assessment of these factors may support individualized counseling and clinical decision-making aimed at reducing cesarean delivery rates.