Repeat external cephalic version. Is it worth the effort?

Abstract

OBJECTIVE: To determine whether repeat external cephalic version subsequent to initial failed version resulted in a decreased cesarean section rate and hospital cost. STUDY DESIGN: All women who underwent repeat external cephalic version after initial failed version were identified and their charts reviewed. Data collected included success of version, mode of delivery, presentation in labor, hospital days, hospital cost, parity and birth weight. RESULTS: Thirty-six women had a repeat external cephalic version attempt from 1987 to 1992. Six, or 17%, of these were successful. All the successful versions were vertex in labor and had a vaginal delivery. Only 6, or 21%, of the failed versions had a vaginal delivery (P < or = .0002). The mean hospital stay was 2.0 and 3.0 days in the successful and failed groups, respectively. The mean hospital cost, expressed in 1992 dollars, was significantly greater in the failed group: $8,042 vs. $5,059 (P < or = .03). CONCLUSION: Repeat version was associated with a decrease in the cesarean section rate and hospital cost and should be considered in the management of nonvertex term presentations.