Procedural Optimisation and Unmeasured Implementation in External Cephalic Version at Term: A Narrative Review of a Measurement Asymmetry.
4 affiliations
- 1Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
- 2Department of Obstetrics and Gynecology, Cuza Voda Hospital, 700038 Iasi, Romania.
- 3Department of Ophthalmology, Emergency Clinical Hospital "Prof. Dr. Nicolae Oblu", 700309 Iasi, Romania.
- 4Department of Obstetrics and Gynecology, Clinical Hospital of Obstetrics and Gynecology "Elena Doamna", 700038 Iasi, Romania.
Abstract
Caesarean delivery is rising worldwide, and for breech presentation at term, external cephalic version (ECV) reduces non-cephalic presentation at birth and, at very low certainty, caesarean delivery. Procedural evidence is reported per attempt, whereas losses determining whether an eligible woman reaches an attempt occur earlier and, in the literature we retrieved, are rarely measured. This narrative review compares procedural evidence with what is recorded about progression to ECV. Immediate success occurs in roughly half to six in ten attempts. Severe procedure-attributable complications are uncommon under strict definitions, at 0.24% in pooled data and 0.45% in a large series, whereas broader short-term composites reach 6-10% and count different events. Attempt rates were 62.2% and 72.5% of eligible women in two Dutch cohorts and 7.9% of a source-defined cohort in United States data, over non-comparable denominators. No contemporary study identified in our search reports the proportion of eligible women offered ECV in ordinary clinical practice, with eligibility assessed in every term breech presentation, despite an auditable standard targeting 100%. We identified no study measuring procedural effects and losses before the attempt within one population. Utilisation varies markedly, but the extent of any underuse cannot be quantified from this documented, non-exhaustive search. We set out an author-derived nine-state pathway with explicit denominators and three proposed process indicators as a reporting framework, not as validated measures.
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BibTeX
@article{carauleanu2026procedural,
title = {{Procedural Optimisation and Unmeasured Implementation in External Cephalic Version at Term: A Narrative Review of a Measurement Asymmetry.}},
author = {Alexandru Cărăuleanu and Vasile Adrian Sescu and Claudia Florida Costea and Raluca Haba and Iustina Petra Solomon Condriuc and Raluca Anamaria Mogoș and Răzvan Socolov and Demetra Socolov},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/healthcare14203452},
url = {https://europepmc.org/article/MED/42940496},
note = {CC BY},
}
RIS
TY - JOUR
TI - Procedural Optimisation and Unmeasured Implementation in External Cephalic Version at Term: A Narrative Review of a Measurement Asymmetry.
AU - Alexandru Cărăuleanu
AU - Vasile Adrian Sescu
AU - Claudia Florida Costea
AU - Raluca Haba
AU - Iustina Petra Solomon Condriuc
AU - Raluca Anamaria Mogoș
AU - Răzvan Socolov
AU - Demetra Socolov
PY - 2026
DA - 2026/10/15
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14203452
UR - https://europepmc.org/article/MED/42940496
AB - Caesarean delivery is rising worldwide, and for breech presentation at term, external cephalic version (ECV) reduces non-cephalic presentation at birth and, at very low certainty, caesarean delivery. Procedural evidence is reported per attempt, whereas losses determining whether an eligible woman reaches an attempt occur earlier and, in the literature we retrieved, are rarely measured. This narrative review compares procedural evidence with what is recorded about progression to ECV. Immediate success occurs in roughly half to six in ten attempts. Severe procedure-attributable complications are uncommon under strict definitions, at 0.24% in pooled data and 0.45% in a large series, whereas broader short-term composites reach 6-10% and count different events. Attempt rates were 62.2% and 72.5% of eligible women in two Dutch cohorts and 7.9% of a source-defined cohort in United States data, over non-comparable denominators. No contemporary study identified in our search reports the proportion of eligible women offered ECV in ordinary clinical practice, with eligibility assessed in every term breech presentation, despite an auditable standard targeting 100%. We identified no study measuring procedural effects and losses before the attempt within one population. Utilisation varies markedly, but the extent of any underuse cannot be quantified from this documented, non-exhaustive search. We set out an author-derived nine-state pathway with explicit denominators and three proposed process indicators as a reporting framework, not as validated measures.
SN - 2227-9032
ER -