External Cephalic Version (ECV)

Question 1

Function

Answer 1

To reduce number of caesarean section due to breech presentation

Question 2

performed with

Answer 2

tocolytic (e.g nifedipine)

Question 3

Procedure

Answer 3

Woman is laid flat with left lateral tilt having ensured that she has emptied her bladder and is comfortable.
2. With ultrasound guidance, the breech is elevated from pelvis and one hand is used to manipulate this upward in the direction of a forward role while other hands applies gentle pressure to flex the fetal head and bring it down to maternal pelvis

Question 4

Precaution

Answer 4

• Procedure should be mildly uncomfortable for mother and should not more than 10 minutes.
• Procedure fail, it is abandoned

Question 5

Contraindications

Answer 5

• Fetal abnormality (e.g hydrocephalous)
• Placenta previa
• Oligohydramnios or polyhydramnios
• History of antepartum hemorrhage
• Previous caesarian or myomectomy scar on the uterus
• Multiple gestation
• Pre-eclampsia or hypertension
• Plan to deliver by caesarean section anyway.

Question 6

Risk

Answer 6

• Placenta abruption
• Premature rupture of membranes
• Cord accident
• Transplacental haemorrhage
• Fetal bradycardia

Question 7

Mode of delivery

Answer 7

Caaesarian section