ECV

Question 1

What is success rate of ECV?

Answer 1

58%

Question 2

What factors decrease success rates?

Answer 2

• Obesity
• Frank or footling breech
• oligohydramnios
• anterior placenta
• short nuchal cord

Question 3

contraindications

Answer 3

maternal

• maternal cardiac disease
• previous classic cesarean delivery
• GHTN
• congenital uterine anomalies (or large submucosal fibroids)

fetal

• IUGR
• multiple gestations
• NR FHT
• fetal anomaly

OB

• PROM
• unexplained uterine bleeding
• previa
• uteroplacental insufficiency
• oligohydramnios

Question 4

when/how to prepare?

Answer 4

• at 37 weeks
• weekday
• notify anesthesia, NPO midnight
• active T+S, CBC option but not recommended
• preform US to note: fetal presentation, location of fetal spine, type of breech, placental location, amniotic fluid volume, cord length, uterine anomalies
• get reactive NST
• check for cervical dilation

**Rh Ig if Rh negative and delivery not anticipated in 72 hours

Question 5

role of neuraxial anesthesia? tocolytics?

Answer 5

good evidence that parenteral tocolytic (0.25 SQ or IVterb). nxa may help, reasonable to offer, esp in conjunction with tocolysis

Question 6

ECV decreases risk of CD by how much?

Answer 6

43%