Background/Aims: The outcomes of external cephalic versions (ECV) performed at the University Hospital Graz in Austria were analyzed to determine to what extent the cesarean section rate can be reduced by an ECV program. Methods: All women who were admitted to the hospital with breech presentation at 37 weeks or later and underwent an attempt of ECV between 2002 and 2004 were recorded and retrospectively analyzed. Results: Of 136 cases51% were successful. Among these, the cesarean section rate was 13%. The cesarean section rate among all not successful cases was 82%. Of the successful cases which remained in cephalic presentation 92% were delivered vaginally and 5 were delivered by cesarean section. The cesarean section rate (8%) was slightly higher than in fetuses with cephalic presentation observed at the onset of contractions in 2004 (5.9%). No maternal or fetal complications or side effects occurred. Conclusion: Successful ECV beyond 37 weeks of gestation significantly decreases the cesarean section rate. ECV reduces the cesarean section rate among breech positions and decreases the risks related to breech delivery, when correctly performed and adequately monitored. ECV reduces higher costs connected with cesarean section.

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