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C-section likely: severe obesity linked to failure of external cephalic version.(Obstetrics)

OB GYN News

| August 15, 2004 | Bates, Betsy | COPYRIGHT 2004 International Medical News Group. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

EDMONTON, ALTA. -- Chances are slim that a morbidly obese woman with a breech presentation will have a vaginal delivery, even if external cephalic version is successful, investigators reported at the annual meeting of the Society of Obstetricians and Gynaecologists of Canada.

"Severe obesity was associated with a lowered rate of successful ECV and a very high rate of failed trial of labor," said Dr. Emmanuel Bujold, a coordinator of a prospective observational study of external cephalic version (ECV) at Sainte-Justine Hospital at the University of Montreal.

The researchers studied 854 patients undergoing a trial of ECV between 1987 and 2001. Success correlated well with multiparity, use of tocolytic drugs, adequate amniotic fluid volume, location of the placenta, and estimated fetal weight greater than 3,000 g.

The greatest predictor of failure in a multivariate regression analysis was a maternal body mass index greater than 35 kg/[m.sup.2], defined in the study as morbid obesity. (See table.)

There were 46 patients who met that definition, compared with 185 patients with a normal BMI less than 25; 276 ...


    
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