Table 3.
Description of ECV procedures
| Description of procedures | Early ECVn (%) | Delayed ECVn (%) |
|---|---|---|
| n = 765 | n = 769 | |
| Time from randomisation to first ECV procedure | ||
| ≤7 days | 571 (74.6) | 10 (1.3) |
| >7 days | 44 (5.8) | 451 (58.7) |
| No ECV procedure undertaken | 150 (19.6) | 308 (40.1) |
| Reasons for no ECV procedure* | ||
| Spontaneous version | 106 (13.9) | 194 (25.2) |
| Mother declined ECV | 29 (3.8) | 47 (6.1) |
| Developed contraindication to ECV | 14 (1.8) | 33 (4.3) |
| Mother delivered before ECV | 1 (0.1) | 34 (4.4) |
| Clinician declined | 3 (0.4) | 6 (0.8) |
| Logistics | 2 (0.3) | 1 (0.1) |
| Other† | 0 | 2 (0.3) |
| ECV procedure | 615 (80.4) | 461 (60.0) |
| n = 615 | n = 461 | |
| Gestational age at first ECV procedure | ||
| Median (weeks) (5–95th centile) | 35.1 (34.0, 35.9) | 37.3 (36.9, 37.9) |
| <340/7 | 14 (2.3) | 0 (0.0) |
| 340/7–356/7 | 584 (95.0) | 5 (1.1) |
| 360/7–366/7 | 12 (2.0) | 26 (5.6) |
| ≥370/7 | 5 (0.8) | 430 (93.3) |
| Fetal presentation before first ECV procedure | ||
| Frank breech | 372 (60.5) | 275 (59.7) |
| Complete breech | 189 (30.7) | 144 (31.2) |
| Footling breech | 31 (5.0) | 24 (5.2) |
| Unknown breech | 6 (1.0) | 1 (0.2) |
| Transverse/oblique lie | 17 (2.8) | 17 (3.7) |
| Position of breech at first ECV procedure | ||
| Sacrum anterior | 120 (20.1) | 91 (20.5) |
| Sacrum posterior | 71 (11.9) | 47 (10.6) |
| Sacrum transverse | 353 (59.0) | 266 (60.0) |
| Unknown | 54 (9.0) | 40 (9.0) |
| Station of presenting part before first ECV procedure | ||
| Floating | 236 (38.4) | 121 (26.3) |
| Dipping | 244 (39.7) | 209 (45.3) |
| Well into the pelvis orengaged | 122 (19.8) | 124 (26.9) |
| Unknown | 13 (2.1) | 7 (1.5) |
| Fetus easily palpated before first ECV procedure | ||
| Yes | 518 (84.2) | 414 (89.8) |
| No | 94 (15.3) | 45 (9.8) |
| Unknown | 3 (0.5) | 2 (0.4) |
| Use of tocolytics for ECV | ||
| During all ECV procedures | 419 (68.1) | 316 (68.6) |
| During some ECV procedures | 10 (1.6) | 8 (1.7) |
| During no ECV procedures | 186 (30.2) | 136 (29.5) |
| Tocolytics used* | ||
| Betamimetic | 335 (54.5) | 252 (54.7) |
| Nitric oxide donor | 36 (5.9) | 23 (5.0) |
| Oxytocin antagonist | 29 (4.7) | 30 (6.5) |
| Calcium channel blocker | 27 (4.4) | 15 (3.3) |
| Prostaglandin synthetase inhibitor | 19 (3.1) | 20 (4.3) |
| Magnesium sulphate | 0 | 1 (0.2) |
| Use of epidural for one or more procedures | 0 (0.0) | 0 (0.0) |
| Use of spinal for one or more procedures | 1 (0.2) | 0 (0.0) |
| Number having same spinal for delivery | 0 (0.0) | 0 (0.0) |
| Success of ECV procedures | ||
| Any ECV procedure successful | 329 (53.5) | 201 (43.6) |
| Only one procedure undertaken | 536 (87.2) | 426 (92.4) |
| First procedure successful | 316 (51.4) | 194 (42.1) |
| Two procedures undertaken | 73 (11.3) | 34 (7.4) |
| Second procedure successful | 22 | 7 |
| More than two procedures undertaken | 6 (1.0) | 0 (0.0) |
| Third or subsequent procedure successful | 3 | |
| Ease with which first successful ECV performed§ | ||
| Very easy | 104 (32.9) | 43 (22.2) |
| Somewhat easy | 121 (38.3) | 81 (41.8) |
| Neither easy nor difficult | 55 (17.4) | 40 (20.6) |
| Somewhat difficult | 29 (9.2) | 27 (13.9) |
| Very difficult | 6 (1.9) | 3 (1.6) |
| Reasons for discontinuing first ECV* | ||
| Unable to turn fetus | 211 (34.3) | 187 (40.6) |
| Unable to lift breech frompelvis | 97 (15.8) | 93 (20.2) |
| Maternal discomfort | 74 (12.0) | 61 (13.2) |
| Non-reassuring fetal heartrate | 11 (1.8) | 11 (2.4) |
| Obese/unable to palpate | 11 (1.8) | 5 (1.1) |
| Other | 4 (0.7) | 6 (1.3) |
| Maternal and fetal complications during ECV* | ||
| Non reassuring fetal heartrate | 21 (3.4) | 16 (3.5) |
| Contractions | 1 (0.2) | 2 (0.4) |
| Hypotension | 1 (0.2) | 2 (0.4) |
| Vaginal bleeding/suspected abruption placenta | 0 | 1 (0.2) |
| Fetal presentation after first ECV | ||
| Cephalic | 316 (51.4) | 194 (42.1) |
| Breech | 283 (46.0) | 250 (54.2) |
| Transverse lie | 16 (2.6) | 17 (3.7) |
| Presentation of fetus after final ECV | ||
| Cephalic | 328 (53.3) | 200 (43.4) |
| Breech | 275 (44.7) | 246 (53.4) |
| Transverse lie | 12 (2.0) | 14 (3.0) |
| Pain during first ECV¶ | ||
| Adjusted Mean (SE)** | 40.6 (1.06) | 45.2 (1.2) |
*
May be more than one reason given.
†
Other reasons in delayed group included an unstable lie and an unfavourable position for ECV with spines posterior.
§
One missing value for early group.
¶
Fifteen missing values in the early group; six missing values in the delayed group.
**
Adjusted for parity, maternal age and weight, and anterior placenta; P = 0.0001.