External cephalic

presentation
• Introduction:
.is the manipulation of fetus
through maternal abdomen to be
a cephalic presentation
•How effective is ECV in
preventing non cephalic
birth??
• women should be informed that sucess rate of ECV
is 50%
• women should be informed that after an
unsuccessful attempt at 36wks GA or later only few
babies presenting by breech will spantanously
turned into cephalic
• Women should be informed that few babies revert
to breech after successful ECV
• Women Should be informed that succesful ECV
reduce the chance of Cesarian section
• Sucess rate of ECV is vary
• Overall sucess rate for multiparous is greater 60% than
nulliparous 40% Due to multiparous women have Lax
abdominal masculature
• Chances of sucess is greater with
• Multiparity
• flexed breech presentation
• adequate liquor volume
• Use of tocolytic
• External cephalic version is done after 36 week GA
as the chance of spantanous version to cephalic
presention after 37 weeks is only 8%
• ECV should be performed in a setting where urgent
cesarian section is available
• CTG for 3
• Contraindication:
• placenta previa
• bleeding within 7 days
• abnormal CTG
• Major uterine anomaly
• previous cesarian or myomectomy scar
• Raptured membrane
• Multiple pregnancy
• pre eclampsia or Hypertension
• planned Caesaraen section
• fetal anomaly e.g( Hydrocephalus)
• Oligohydroaminos or polyhydroamnios
• Pre requisites:
• Women should be laid flat with left lateral tilt
• bladder should be emptied
• presenting part must not be engaged
• Abdomen is fully exposed FHR is ausculted
• uterus is not tonically contracted
• Gestational age more than 36 wks
• there should be adequate amount of liqour to allow easy moment of
fetus
• Commonly used tocolytic terbutaline 0.25 Sc
•
•