About Careers Internship MedBlogs Contact us
Medindia LOGIN REGISTER
Advertisement

Breech Presentation and Delivery - Manual Rotation - External Cephalic Version

Written by Dr. D. Sunitha, MBBS | Medically Reviewed by Dr. Sunil Shroff, MBBS, MS, FRCS (UK), D. Urol (Lond) on Dec 19, 2019
Font : A-A+

Manual Rotation - External Cephalic Version

An External Cephalic Version (ECV) or manually turning the baby from outside the mother's abdomen may be attempted to turn a breech to headfirst.

Advertisement

Women with breech presentation, reassuring fetal heart rate tracings, and no contraindications to vaginal delivery at 36 weeks' gestation and beyond are usually candidates for ECV. ECV is a safe alternative to vaginal breech delivery or cesarean delivery, reducing the cesarean delivery rate for breech by 50%. External cephalic version is nearly always attempted in a hospital with emergency cesarean facilities ready.

  • Procedure

Prepare for the possibility of cesarean delivery. The patient should have nothing by mouth for at least 8 hours prior to the procedure. Perform a non stress test (biophysical profile as backup) prior to ECV to confirm fetal well-being. The Fetal Non-Stress test is a simple, non-invasive test performed in pregnancies over 28 weeks gestation. The test involves attaching one belt to the mother's abdomen to measure fetal heart rate and another belt to measure contractions. Following an ECV attempt, whether successful or not, repeat the nonstress test (biophysical profile if needed) prior to discharge. In those with an unsuccessful ECV, the practitioner has the option of sending the patient home or proceeding with a cesarean delivery.

  • Success rate

Success rates vary widely but range from 35-86% (average, 58%). Improved success rates occur with multiparity, with earlier gestational age, with frank breech presentation, with a transverse lie, and in African American patients. The performance of an ECV decreases the cesarean delivery rate for breech by approximately 50%.

Advertisement
  • Risks of ECV

Uncommon risks of ECV include fractured fetal bones, precipitation of labor or premature rupture of membranes, abruptio placentae, fetomaternal hemorrhage (0-5%), and cord entanglement (<1.5%). A more common risk of ECV is transient slowing of the fetal heart rate (in as many as 40% of cases).

  • Contraindications

a. Absolute contraindications for ECV include

  • Multiple gestations with a breech-presenting fetus.
  • Contraindications to vaginal delivery (eg, herpes simplex virus infection, placenta previa).
  • Non reassuring fetal heart tracing is fetal heart tracing suggestive of hypoxia, which may be Fetal. Tachycardia (>160), Fetal bradycardia(<120),Variable decelerations, and early decelerations.

b. Relative contraindications include

  • Polyhydramnios or oligohydramnios.
  • Fetal growth restriction.
  • Uterine malformation.
  • Fetal anomaly.

Breech Presentation and Delivery - References:

  1. Breech Presentation - (http://www.emedicine.com/med/topic3272.htm)
  2. Breech birth - (http://en.wikipedia.org/wiki/Breech_birth)

Citations   close

Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Dr. D. Sunitha. (2019, December 19). Breech Presentation and Delivery / Breech Birth - Manual Rotation - External Cephalic Version. Medindia. Retrieved on May 19, 2022 from https://www.medindia.net/patients/patientinfo/breech-presentation-delivery-manualrotation.htm.

  • MLA

    Dr. D. Sunitha. "Breech Presentation and Delivery / Breech Birth - Manual Rotation - External Cephalic Version". Medindia. May 19, 2022. <https://www.medindia.net/patients/patientinfo/breech-presentation-delivery-manualrotation.htm>.

  • Chicago

    Dr. D. Sunitha. "Breech Presentation and Delivery / Breech Birth - Manual Rotation - External Cephalic Version". Medindia. https://www.medindia.net/patients/patientinfo/breech-presentation-delivery-manualrotation.htm. (accessed May 19, 2022).

  • Harvard

    Dr. D. Sunitha. 2021. Breech Presentation and Delivery / Breech Birth - Manual Rotation - External Cephalic Version. Medindia, viewed May 19, 2022, https://www.medindia.net/patients/patientinfo/breech-presentation-delivery-manualrotation.htm.


Do you wish to consult an Obstetricians and Gynecologists (OB/GYN) for your problem? Ask your question

Dr. Tamilselvi Arjunan
Dr. Tamilselvi Arjunan
MBBS, DGO, MRCOG, FRCOG
28 years experience
Mangai Womens Health Exclusive, ANNANAGAR
Teleconsult Now View Profile
Dr. Vishnu Vandana Gowthamnath
Dr. Vishnu Vandana Gowthamnath
22 years experience
Chennai Diabetes And Endocrine Clinic, Near Lamech School
Teleconsult Now View Profile
Dr. Arina Chandrababu
Dr. Arina Chandrababu
MS
3 years experience
, Kharghar
Teleconsult Now View Profile
View All

Post a Comment

Comments should be on the topic and should not be abusive. The editorial team reserves the right to review and moderate the comments posted on the site.

Comments

Dr.Niharika

REALLY GOOD EXPLAINATION

sarit.ranjan

use of forcep in after coming head

Advertisement
Health Topics A - Z
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z



    Advertisement
    What's New on Medindia
    Prevent Hacking of Medical Devices: FDA Sounds Alarm
    Black Water: Benefits and Uses
    World Hypertension Day 2022 - Measure Blood Pressure Accurately, Control It, Live Longer!
    View all
    Advertisement

    Medindia Newsletters Subscribe to our Free Newsletters!
    Terms & Conditions and Privacy Policy.

    Most Popular on Medindia

    Blood - Sugar Chart Drug - Food Interactions Find a Doctor Turmeric Powder - Health Benefits, Uses & Side Effects Drug Side Effects Calculator Indian Medical Journals Blood Pressure Calculator How to Reduce School Bag Weight - Simple Tips A-Z Drug Brands in India Color Blindness Calculator

    Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

    © All Rights Reserved 1997 - 2022

    This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use