Prophylactic management of breech presentation by external cephalic version near term

The objective of this study is to add evidence to support or refuse the hypothesis that repeated ECV in late pregnancy reduced the rate of breech presentation at delivery and to find the prognostic factors associated with ECV success. The study included 82 low risk pregnant women 36-40 weeks gestation, diagnosed as single complete breech presentation. Normal real time B-scan examination and reactive non stress test [NST] were prerequisites. From the results obtained it was concluded that, ECV without tocolysis is inexpensive, safe and a reasonable alternative in the management of breech presentation near term, it might be attempted as a routine procedure between 36-40 weeks and the attempts could be repeated till delivery in selected patients. It should be performed preferably in patients with average weight, complete breech presentation with reasonable fetal weight, fetal spine anteriorly, sufficient, liquor amnii and when the placenta is posterior, lateral or fundal in position. Documental fetal well being by reactive non stress test is prerequisite. Thus, trial of unsuccessful vaginal breech delivery is avoided, number of breech presentation at delivery is decreased and unnecessary CS is avoided with definitively decreased maternal and fetal morbidity

Prospective study for safety and efficacy of vaginal examination and membrane stripping at term

One hundred gravid women were included in the study. They were 38 weeks gestation with no medical, surgical or obstetric problems. These women divided equally into 2 groups, the study and the control group. Both groups were matched for age, parity, gestational age and initial Bishop score. All patients had a full examination included the gentle cervico-vaginal examination to assess the initial Bishop score and 30 minutes cardiotocogram. Traumatic vaginal examination was done every week for the control group to assess their Bishop score. The study group underwent weekly stripping of the membranes. The stripped group delivered significantly earlier than the control group [7.8 + 0.58 vs. 14.7 +/- 0.88 days, P <0.001]. Post term deliveries were less frequent in the study group than in the control group [3 vs. 1, P <0.004]. Less frequency of cesarean section in the stripping group than in the control group. Complications were statistically significant minimal with satisfactory fetal and maternal outcome in the study group