External Cephalic Version

GHPI0694_01_07
Author: Maternity
Review due: January 2010
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Patient Information for the
Gloucestershire Health Community
External Cephalic Version

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Procedure for turning the baby
What is external cephalic version?
A vaginal breech delivery may be hazardous for the baby and in
these cases a Caesarean section is recommended. To avoid this it may
be possible to turn a breech baby to a headfirst position External
cephalic version is the changing of a baby’s position in the womb by
manipulation of the mother’s abdomen. If the baby is moved to a
headfirst position, you avoid having a vaginal breech delivery and may
not require a Caesarean section.
When is it used?
External cephalic version (or ECV) may be done when your baby is in
the breech position near your due date. An ultrasound scan will be
done to check the baby’s position and the procedure will be discussed
with you.
Women with the following conditions will be advised against this
procedure:
• Placenta praevia (the placenta is low lying)
• If you need a Caesarean section anyway
• If you have Rhesus antibodies
• If you have twins
• If your waters (membranes) have broken
External cephalic version may also not be advised if you are already in
labour or if your baby has:
• An abnormal heart trace
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• Your baby is small for it’s dates or there is reduced fluid around
the baby
• If you have had a previous Caesarean section
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What happens during the procedure?
The procedure is done in the delivery unit, usually at 2pm. You can
have breakfast but nothing further to eat after 8am (you can have
clear fluids to drink) Please ring the Delivery Unit/Suite at 12.00 to
confirm there is a room available (CGH 08454 222324 or 08454 222325;
GRH 08454 225525). A scan will be done to check the position of
the baby and a heart trace performed to make sure this is normal.
Medication may be given to relax the womb. The doctor then places
his or her hands on your tummy and gently pushes the baby’s bottom
out of your pelvis. The doctor then tries to manoeuvre the baby so
that the head will enter the pelvis.
What happens after the procedure?
After the procedure, whether it has been successful or not, a heart
trace is done again to check the baby’s well being. If it has been
unsuccessful the possibility of a Caesarean section will be discussed.
Even if successful, the baby could turn back to breech again before
you go into labour.
If you have Rhesus negative blood, you may become sensitised if some
of the baby’s blood gets into your circulation. You will be given an
injection of Anti-D to prevent this.
What are the risks associated with this
procedure?
Some of the possible complications of external cephalic version
include:
• A small amount of blood loss from the vagina
• The baby may became distressed
• Damage to the placenta, possibly causing separation of part of it
The likelihood of these complications is very small (1% or less), but any
of these problems can be serious and an emergency Caesarean section
may be needed.
What to do following the procedure?
As long as the baby’s heart trace is normal you will be able to go home
and continue your normal activities. You should phone the Delivery
Unit/Suite (CGH: 08454 222324 or 08454 222325; GRH: 08454225525) if
you have any concerns or think you are in labour.
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