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What is External Cephalic Version

An External Cephalic Version (ECV) is a medical procedure to try and get a breech baby into the correct position for delivery. A breech baby is one that has its bottom or feet ready to be delivered first. This can be a dangerous position to deliver a baby in and often requires a Cesarean section for safety reasons. Because a Cesarean section has its own risks most doctors will want to try and move a baby with an External Cephalic Version first.

Planning and Preparing-

Once your baby has been diagnosed breech, after the 36 week gestation mark your physician may want to try a ECV. This will require setting up an appointment at the hospital. A woman about to have this procedure shouldn’t eat or drink after midnight the night before in case she has to go into surgery. Upon arriving your baby will be given a stress test and usually an ultrasound. This will make sure that everything is set with your baby. External Cephalic Version does have a few risks, and they are looking to make sure your baby is a good candidate for it and ready for it. Usually medication will be given to the mom to relax the uterus and help prevent her from going into labor.

The Maneuver-

Your baby will be hooked up to a monitor to make sure that their heart beat of the baby stays strong. The doctor and often a nurse will then place a hand on the bottom of the baby and the top of the head. They will carefully manipulate the baby by pushing in a circular motion to get the head of the baby into the correct position. An ultrasound may or may not be used during the procedure.

The Results-

Once the doctor is finished manipulating the baby and ultrasound and stress test will be repeated. This will make sure that the baby is in position or not and that he or she has not experienced too much stress. Success rates can be as much as 40-70% successful, but is probably closer to 50-60%. Additionally, even if the baby is in the correct position it may turn back to a breech position.

ECV Dangers-

Few procedures are without some side effects or dangers. The biggest complaint about ECV is that it is uncomfortable and sometimes even painful for the mother. However, there are some other dangers that are much more risky. This procedure can cause the placenta to separate from the uterine wall, it can cause the baby’s heart rate to drop which if it doesn’t correct itself will lead to needing to deliver the baby right away, and it can cause the water to break which can also lead to a need to deliver the baby right away. It is because of these that it should be done in the hospital with an emergency Cesarean Section as an option.

Reasons One Can’t Get An ECV-

Some women are not eligible for an ECV because of increased risks or difficulties. They include women suffering from vaginal bleeding, those whose placenta is near or over the opening of the uterus, those who have a nonreactive non stress test, those with an abnormally small baby, or a low level of amniotic fluids. It is also impossible to do an External Cephalic Version once there is a rupturing of the membranes (the water breaks) whether it is premature or not. Additionally this procedure doesn’t work if the woman is pregnant with more then one baby such as twins or multiples.

While an External Cephalic Version isn’t a great option, it is often the best option. Having an ECV is a better option then a Cesarean Section and is usually worth the risks. It also contains a low level of risks, other then discomfort to the mother.