ECV may be more successful when done early. (Clinically Significant Trend).

WINNIPEG, MAN. -- Physicians who attempt external cephalic version of a breech fetus at 34-36 weeks' gestation may have slightly more success than those who attempt it at 37-38 weeks, according to the results of the Early External Cephalic Version Trial.

Although the results of the trial did not show a statistically significant difference in the success rate based on the timing of the procedure, there was a clinically significant trend toward a higher success rate when the procedure was performed earlier, said Eileen Hutton, principal investigator for the multicenter, international trial.

A total of 233 women from seven countries who had breech presentations were randomized to external cephalic version (ECV) at 34-36 weeks' gestation or 37-38 weeks. Women who underwent ECV early had a 9.5% reduction in noncephalic presentation at birth and a 7% reduction in cesarean section rates, compared with those who had late ECV, she said at the annual meeting of the Society of Obstetricians and Gynecologists of Canada.

"We now need to go to a larger trial to make sure the finding is a true one and not just a chance finding. This study had a significance value of 0.09, which means there's a 9% chance that the finding was just by chance," she said in an interview.

Interest in ECV has grown enormously in recent months, fueled by the results of the Term Breech Trial. In that study, planned cesarean section for breech pregnancies was associated with a lower rate of perinatal and neonatal mortality and serious neonatal morbidity, compared with planned vaginal delivery (1.6% vs. 5%).

"The results of the Term Breech Trial have meant that the majority of women with breech babies are now going to be offered cesarean sections, whereas previously the majority of ...