The relation between umbilical cord characteristics and the outcome of external cephalic version

Abstract

Background: Umbilical cords of fetuses in breech presentation differ in length and coiling from their cephalic counterparts and it might be hypothesised that these cord characteristics may in turn affect ECV outcome.

Aim: To investigate the relation between umbilical cord characteristics and the outcome of external cephalic version (ECV).

Study design: Prospective cohort study.

Subjects: Women (>35 weeks gestation) with a singleton fetus in breech presentation, suitable for external cephalic version. Demographic, lifestyle and obstetrical parameters were assessed at intake. ECV success was based on cephalic presentation on ultrasound post-ECV. Umbilical cord length (UCL) and umbilical coiling index (UCI) were measured after birth.

Outcome measure: The relation between umbilical cord characteristics (cord length and coiling) and the success of external cephalic version.

Results: ECV success rate was overall 79/146 (54%), for multiparas 37/46(80%) and for nulliparas 42/100 (42%). Multiple logistic regression showed that UCL (OR: 1.04, CI: 1.01-1.07), nulliparity (OR: 0.20, CI: 0.08-0.51), frank breech (OR: 0.37, 95% CI: 0.15-0.90), body mass index (OR: 0.85, CI: 0.76-0.95), placenta anterior (OR: 0.27, CI: 0.12-0.63) and birth weight (OR: 1.002, CI: 1.001-1.003) were all independently related to ECV success.

Conclusions: Umbilical cord length is independently related to the outcome of ECV, whereas umbilical coiling index is not.