On “Mode of Delivery Following Successful External Cephalic Version” (Am J Perinatol 2002;19:355-360)

I read with interest the article “Mode of Delivery Following Successful External Cephalic Version” by Ben-Haroush et al (Am J Perinatol 2002; 19:355-360). The authors noted an increased risk of cesarean for malpresentation and dystocia following successful external cephalic version (ECV). Our study previously published in the same journal, yet not referenced by these authors, found no differences in the length of labor or mode of delivery (spontaneous vaginal, operative vaginal, or cesarean) after ECV as compared to controls with naturally vertex fetuses.[1] Another investigation by Siddiqui et al, and also not referenced by Ben-Haroush et al, failed to demonstrate an increase in cesareans following successful ECV.[2]

In contrast to the current study, we matched cases and controls for gestational age at delivery, labor onset (spontaneous versus induced), prior vaginal delivery, and cervical dilation at admission in labor. Of concern, labor induction and cervical dilation on admission-factors recognized as impacting likelihood of vaginal delivery-were not reported in the current study.[3] Moreover, the mean newborn birth weights were significantly greater among cases than controls, potentially accounting for the apparent increase in cesarean rate after ECV. We welcome additional well-designed studies addressing the issue of labor and delivery following successful ECV.

REFERENCES

• 1 Wax J R, Sutula K, Lerer T, Steinfeld J D, Ingardia C J. Labor and delivery following successful external cephalic version.  Am J Perinatol . 2000;  17 183-186
• 2 Siddiqui D, Stiller R, Collins J, Laifer S A. Pregnancy outcome after successful external cephalic version.  Am J Obstet Gynecol . 1999;  181 1092-1095
• 3 Williams M C, Krammer J, O'Brien W F. The value of the cervical score in predicting successful outcome of labor induction.  Obstet Gynecol . 1997;  90 784-789