Poster Session 1
Dhanalakshmi Thiyagarajan, MD, MPH (she/her/hers)
University of Michigan
Ann Arbor, Michigan, United States
Jessica McCoy, BA (she/her/hers)
University of Michigan
Ann Arbor, MI, United States
Mackenzie Woock
University of Michigan
Ann Arbor, Michigan, United States
Promise Sefogah, MBBCH, MPH
University of Ghana
University of Ghana, Greater Accra, Ghana
Samuel Oppong, MBBCH
University of Ghana
University of Ghana, Greater Accra, Ghana
Nana Essuman Oduro, MBBCH, MPH
University of Ghana
University of Ghana, Greater Accra, Ghana
Alim Swarray-Deen, MBBCH, MSc (he/him/his)
University of Ghana Medical School
University of Ghana Medical School, Greater Accra, Ghana
To understand outcomes after the implementation of external cephalic version (ECV).
We conducted a quasi-experimental study of patients with malpresentation at an urban teaching hospital in Ghana. Patients with multiple gestation or presenting with intrauterine fetal demise were excluded. Demographics and medical history of those presenting for delivery complicated by malpresentation between January 2012 to December 2015 were collected. The practice of ECV was implemented by the Obstetrics and Gynecology Department between 2016-2018. Demographics and medical history of those receiving ECVs between January 2019 to December 2022 were collected. We performed descriptive statistics.
From 2012 to 2015, data was available for 1,789 patients who presented for delivery with malpresentation. Our study included 1,739 patients after excluding incomplete data entries. From 2019 to 2022, data was available for 133 patients who underwent ECV. Our study included 72 patients after excluding incomplete data entries.
Prior to implementation of ECV, 438 (25%) and 1,301 (75%) had vaginal breech and cesarean deliveries, respectively. Overall, 122 (7%) of malpresentations resulted in intrapartum fetal demise. Ninety-five (22%) of the vaginal deliveries, and 27 (2.1%) of the cesarean deliveries were complicated by intrapartum fetal demise.
After implementation of ECV, 39 (54%) had spontaneous, breech, or operative vaginal deliveries, and 33 (46%) had cesarean deliveries. There was no intrapartum fetal demise.
Of the 72 ECVs, 53 (74%) were successful. When presenting for delivery, 48 (91%) remained in the cephalic presentation. Of those with successful ECV and remaining in the cephalic presentation, 35 (73%) had a spontaneous or operative vaginal delivery, and 13 (27%) had a cesarean delivery.
The implementation of ECV resulted in the reduction of intrapartum fetal demises and cesarean deliveries. Our research suggests external cephalic version is a practical, feasible, and implementable intervention that can be integrated into low- and middle-income countries’ hospitals.
