Breech Presentation Clinical Trial
Background: The incidence of breech presentation in pregnant women is 4%. The situation can
be treated by two methods. The first is a version of the fetus from breech presentation to
head presentation, which can be performed in several ways, such as, an action called
EXTERNAL CEPHALIC VERSION as well as the Knee-Chest position by the pregnant mother and the
second is a cesarean section. In this study we wish to investigate if the Knee-Chest
position is as effective as the ECV action and as a result to decrease the need for ECV.
Hypotheses: According to our assumption, the Knee-Chest position can reduce the need for the
ECV action.
Objectives: Investigate whether daily Knee-Chest position is as effective as ECV.
Methods: The investigators will conduct a "randomized clinical trial" study. Every pregnant
woman in a breech presentation with a singleton between weeks 28-32 will be randomly
assigned into one of two groups. In the first group the women will perform daily the
Knee-Chest position between weeks 32-37. In week 37 the investigators will check via ultra
sound if there was a successful version (if not, the woman would go to ECV) in the second
group we will perform ECV without doing maternal Knee-Chest position before. Every woman
will fill a questionnaire which includes gynecological history and details regarding the
degree of persistence and performance of the activity. At the end of this process the
investigators will analyze the results and will come to the conclusions.
Significance: With ECV there are number of risks and complications such as fetal distress,
placental abruption, rupture of membrane, amniotic fluid embolism or damage to the uterus.
The frequency of these complications is 1%-2%. If it is discovered that the Knee-Chest
position is effective as the ECV action, the investigators will recommend every patient to
persist with this position and avoid the ECV action and the risks it entails.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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