EXTERNAL CEPHALIC VERSION

Course overview

ABOUT 25 PERCENT OF FETUSES WILL BE IN BREECH PRESENTATION AT 28 WEEKS, THOUGH THIS DECREASES TO ROUGHLY 3 TO 4 PERCENT AT TERM. MOST INFANTS WHO ARE IN BREECH PRESENTATION AT THE TIME OF DELIVERY WILL REQUIRE A CESAREAN DELIVERY. HOWEVER, AN ALTERNATIVE TO IMMEDIATELY PROCEEDING WITH CESAREAN SECTION IS A TRIAL OF EXTERNAL CEPHALIC VERSION. THIS PROCEDURE SUCCESSFULLY BRINGS THE FETUS INTO THE VERTEX POSITION, THE IDEAL POSITION FOR A VAGINAL BIRTH, ABOUT 58 PERCENT OF THE TIME. EXTERNAL CEPHALIC VERSION IS PERFORMED STRATEGICALLY PLACING THE HANDS ON THE GRAVID ABDOMEN AND APPLYING PRESSURE TO ENCOURAGE THE FETUS TO MOVE INTO THE VERTEX POSITION. THIS CAN BE ATTEMPTED FOR FETUSES IN THE BREECH, TRANSVERSE, OR OBLIQUE POSITIONS AND HAS THE POTENTIAL TO DECREASE CESAREAN DELIVERY RATES. THIS ACTIVITY REVIEWS THE INDICATIONS, CONTRAINDICATIONS, AND TECHNIQUE INVOLVED IN PERFORMING EXTERNAL CEPHALIC VERSION AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN THE CARE OF PATIENTS UNDERGOING THIS PROCEDURE.