{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:36:36Z","timestamp":1792092996640,"version":"4.4.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T00:00:00Z","timestamp":1733443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>One of the key challenges regarding the management of twins involves choosing the optimal mode of delivery, which is strongly influenced by the final presentation of both fetuses. In cases of vertex\u2013nonvertex pregnancies attempting the trial of vaginal delivery, external cephalic version (ECV) is one of possible management options. The main objective of this review was to collect and summarize available data in terms of the application of ECV in the population of nonvertex second twins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>Using the PRISMA guidelines, we searched for original, English\u2010language studies investigating ECV in nonvertex second twins. The PubMed\/MEDLINE, SCOPUS, and COCHRANE databases were searched until May 2024. Reviews, case reports, editorials, and conference papers were excluded from further analysis. Out of 260 papers retrieved, 10 were subjected to the final analysis in terms of success rates, modes of delivery, and adverse outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total number of ECVs was 289, with an overall success rate of 64.4%. In the group of successful versions, vertex vaginal delivery was achieved in 171 cases (91.9%). The incidence of adverse maternal and neonatal outcomes was low.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The purpose of this review was to consolidate and update the current knowledge regarding ECV in nonvertex second twins. Based on the results of this series of studies, ECV appears to be a reasonable management option. However, it is important to highlight several significant limitations. The primary concern is the lack of recent research in this field over the past three decades, with the most recent study in our review being published in 1998. Furthermore, the actual number of studies addressing this topic is relatively low, characterized by a retrospective nature and questionable methodologies. These limitations make it challenging to draw definitive conclusions for clinical practice. This is an important message for our community, emphasizing the need for further studies in this area, particularly randomized controlled trials, to evaluate the safety and success rate of vaginal twin delivery after ECV when the second twin presents in a nonvertex position.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.15006","type":"journal-article","created":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T12:04:15Z","timestamp":1733486655000},"page":"584-590","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["External cephalic version in nonvertex second twin\u2014Success rate, mode of delivery, and safety: A systematic review"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3989-2013","authenticated-orcid":false,"given":"Mi\u0142osz","family":"Dymon","sequence":"first","affiliation":[{"name":"Faculty of Medicine Lazarski University  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5780-5983","authenticated-orcid":false,"given":"Micha\u0142","family":"Ciebiera","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynecology Center of Postgraduate Medical Education  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Zgliczy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Perinatology and Neonatology Center of Postgraduate Medical  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Siergiej","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Lazarski University  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakub","family":"Kociuba","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynecology Center of Postgraduate Medical Education  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Szajnik","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Lazarski University  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,6]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"1","article-title":"Three decades of twin births in the United States, 1980\u20132009","volume":"80","author":"Martin JA","year":"2012","journal-title":"NCHS Data Brief"},{"key":"e_1_2_11_3_1","first-page":"1","article-title":"Births: final data for 2021","volume":"72","author":"Osterman MJK","year":"2023","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000227747.37184.0a"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.09.132"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214939"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02840-3"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.08.039"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12449"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.5603\/GP.a2018.0110"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14466"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31818b4ade"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(91)90216-E"},{"key":"e_1_2_11_15_1","unstructured":"National Heart L Institute B.Quality Assessment Tool for Observational Cohort and Cross\u2010Sectional Studies.2014."},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199203000-00019"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1520-6661(199705\/06)6:3<146::AID-MFM5>3.0.CO;2-L"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(98)70179-6"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0028-2243(95)80016-L"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(12)80009-3"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(89)90245-7"},{"key":"e_1_2_11_22_1","first-page":"160","article-title":"Intrapartum external version of the second twin","volume":"62","author":"Chervenak FA","year":"1983","journal-title":"Obstet Gynecol"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(95)91319-X"},{"key":"e_1_2_11_24_1","first-page":"383","article-title":"Management of the nonvertex second twin","volume":"172","author":"Wells SR","year":"1991","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15475"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.14385"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6277"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.03.008"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13234"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2012.663828"},{"key":"e_1_2_11_31_1","article-title":"Interventions for helping to turn term breech babies to head first presentation when using external cephalic version","volume":"2015","author":"Cluver C","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14724"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38919.681563.4F"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.15006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T17:09:32Z","timestamp":1743786572000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.15006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,6]]},"references-count":32,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1111\/aogs.15006"],"URL":"https:\/\/doi.org\/10.1111\/aogs.15006","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,6]]},"assertion":[{"value":"2024-07-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}