Abstract
Objective: The aim of this study is to evaluate the clinical and sonographic predictors of
ultimate successful vaginal delivery in women undergoing external cephalic version.
Study design: The study population consisted of women with external cephalic version performed
at or after 36 weeks of gestation. They were randomized into group A or B, each consisted
of half of the total study population. Logistic regression was performed on group
A to identify the significant independent variables in predicting successful cephalic
vaginal delivery, which were used to construct a prediction model. The derived regression
model was then tested in group B to assess its accuracy. Results: The study included 407 pregnancies. Maternal weight (kg) at the time of version,
maternal height (cm), multiparity, engagement of fetal presenting part, and fetal
head palpable were significant independent variables of successful version and vaginal
delivery (regression coefficients are: −0.084, 0.085, 1.752, −1.271, and 0.725, respectively).
A prediction model was constructed based on these independent variables. The weighted
average of the overall accuracy in predicting success or failure of version and vaginal
delivery was 70.9%. The regression model was then applied to study group B. Using
0.50 as the cutoff value, the sensitivity, specificity, positive, and negative predictive
values were 75.4, 58.8, 73.7, and 61.0%, respectively. Conclusion: A regression model constructed based on clinical variables failed to provide an
accurate predictive tool of successful external cephalic version and vaginal delivery.
However, in women who are equivocal about external cephalic version, a high prediction
of success would be encouraging.
Keywords
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Article info
Publication history
Accepted:
February 5,
2004
Received in revised form:
January 1,
2004
Received:
August 17,
2003
Identification
Copyright
© 2004 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
