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External Cephalic Version

AMBULATORY CARE:

External cephalic version

is a procedure used to move your baby into a headfirst position in your womb. This is usually done at around week 37 of pregnancy. A rear-first or feet-first position is called a breech position. This position can cause problems for the baby during pregnancy or delivery. Examples include a hip dislocation and nerve or brain injury. Babies in a breech position may need to be delivered by cesarean section (C-section). External cephalic version may help prevent problems during delivery.

What will happen before an external cephalic version:

  • Your obstetrician will tell you how to prepare for this procedure. You may be told not to eat or drink anything for 8 hours before this procedure. This is because external cephalic version can sometimes cause problems that may an immediate C-section necessary. Arrange to have someone drive you home from the procedure and stay with you for the rest of the day.
  • An ultrasound will be done to make sure your baby is in a breech position.
  • Your baby's heart rate will be watched closely with a monitor.
  • You may get medicine in your IV or injected into a muscle to help prevent contractions. Medicine may also be given to help the muscles in your uterus relax.

What will happen during an external cephalic version:

Gentle pressure will be used to prevent problems for you or your baby. An ultrasound or other test will be used several times during the procedure to check your baby's heart rate.

  • You will lie on your back. Your obstetrician will put his or her hands on your abdomen to find your baby's head.
  • First a forward roll will be tried. Your obstetrician will use one hand to lift your baby's buttocks out of your pelvis. The other hand will move your baby's head down toward your pelvis.
  • If this does not work, your obstetrician will try a backward roll. This means one hand will hold your baby's buttocks, and the other hand will push your baby toward your right hip. The baby will also be moved upward. His or her head may be moved down toward your left hip.

What will happen after an external cephalic version:

  • Your baby's heart rate will be checked again. If it is normal, you may be able to go home.
  • If the procedure worked, your obstetrician will help you make a birth plan if you want to have a vaginal delivery. Plans for a C-section may also be created, in case your baby has problems or turns back into a breech position. You may also need or want a C-section if the procedure did not work.
  • Your obstetrician will tell you when to return for more tests before you deliver. He or she will also give you instructions on what to do at home until labor begins.

Risks of an external cephalic version:

You may feel some pain or discomfort during the procedure. You may also have nausea, and you may vomit. This procedure may cause labor to start, or cause premature rupture of the membranes (PROM). PROM means fluid leaks from your amniotic sac before labor begins. The placenta may pull away from the uterus, called abruption. You or your baby may also lose blood. Your baby's heart rate may become too slow. Your baby may turn back into a breech position even after a successful external cephalic version. During delivery, your baby may have a dislocated hip. His or her shoulder may get stuck in the birth canal (called shoulder dystocia). You may need to have a C-section to deliver your baby if he or she is in distress.

Seek care immediately if:

  • You develop a severe headache that does not go away.
  • You have new or increased vision changes, such as blurred or spotted vision.
  • You have new or increased swelling in your face or hands.
  • You have vaginal spotting or bleeding.
  • Your water broke or you feel warm water gushing or trickling from your vagina.

Contact your healthcare provider if:

  • You have more than 5 contractions in 1 hour.
  • You notice any changes in your baby's movements.
  • You have abdominal cramps, pressure, or tightening.
  • You have questions or concerns about your condition or care.

Care for yourself and your baby:

  • Rest as needed. Put your feet up if you have swelling in your ankles and feet.
  • Follow your obstetrician's directions about activity. You should not do anything strenuous (physically difficult) for several days after the procedure. Your obstetrician can tell you which daily activities are okay for you to do until labor begins. Stop anything you are doing if you feel pain or pressure in your abdomen.

Follow up with your obstetrician as directed:

You may need to have another ultrasound to check that your baby is not in a breech position again. Other tests may be used to check your baby's condition. Write down your questions so you remember to ask them during your visits.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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