Version Flashcards
A number of special procedure which the physician may use to assist the mother in labor and delivery
Operative Obstetrics
Turning the fetus, is a procedure used to change the fetal presentation by abdominal or intrauterine manipulation
Version
the presentation of the fetus is changed from a breech, shoulder, or oblique to a cephalic presentation by external manipulation of the maternal abdomen
External Cephalic Version
criteria for ECV
1.) Pregnancy is 37 or more weeks of gestation but before the woman is in labor
2.) Reactive nonstress test
3.) Fetal breech is not engaged
Contraindications for ECV
1.) Previous CS birth or other uterine birth
2.) CPD
3.) Fetal size 4000g or larger
4.) Multiple Gestation
5.) Non reassuring FHR
Prerequisites for ECV
1.) UTZ is used to locate placenta and to confirm fetal presentation and gestational age and determine the adequacy of amniotic fluid
2.) FHR monitoring
3.)) Tocolytic agent is administered to relax uterus (Terbutaline)
Version Risks
1.) FHR changes
2.) fetus may become entangled in or compress the cord
3.) Abruptio placenate
4.) Mixing of fetal and maternal blood with in small breaks in placenta vessels
Procedure for turning the baby
1.) The baby is in breech position
2.) The doctor feels for the baby’s head and bottom
3.) the doctor turns the baby around
4.) The baby is in for normal delivery
used only with the 2nd twin during vaginal birth and only if the twin does not decend readily or if the heart rate is non reassuring
OB places hand into uterus and with the other hand on the maternal abdomen maneuver the fetus into a longitudinal lie
Internal Podalic Version
Management
1.) Explain procedure to patient
2.) Before procedure ask patient to empty bladder
3.) if negative contraindications, assess maternal VS and reactive NST are obtained
4.) fetal well being is ascertained before intermittently during and for atleast 30 minutes following the procedure using EFM and UTZ
