PB 221: External Cephalic Version Flashcards
What is the percentage of breech presentation in term pregnancies?
3-4%
What is the goal of External Cephalic Version (ECV)?
Decreases C/S rate and increases VD rate
What are the benefits of ECV?
- Decreased chance of C/S
- Lower hospital charges
- Lower odds of developing endometritis, sepsis
- Shorter length of hospital stay
What are the risks of ECV?
The following risks occur at a rate of < 1%:
- Placental abruption
- Umbilical cord prolapse
- Rupture of membranes
- Stillbirth
- Fetomaternal hemorrhage
What are the success rates for ECV?
~50%
What factors are predictive of ECV failure?
- Nulliparity
- Advanced dilatation
- EFW less than 2500 g
- Anterior placenta
- Low station
How does the use of tocolysis affect the success rate of external cephalic version?
A randomized study of terbutaline found the success rate of ECV associate with its use to be almost double the success rate without its use
How does the use of anesthesia affect the success rate of ECV?
Neuraxial analgesia can be considered a reasonable intervention to increase ECV success rate
What is the algorithm for patient management for ECV?
What is an example of a standard protocol for performing an ECV?
- U/S to confirm malpresentation
- Informed consent
- Fetal well-being and contraction pattern before and after procedure
- Use U/S to guide evaluation during procedure
- Give Rhogam to Rh negative patients if delivery is not anticipated in the next 72 hours
Summary of Recommendations: Level A and B
