External Cephalic Version and Reducing the Incidence of Breech Presentation

Background External cephalic version (ECV)is manipulations performed through the abdominal wall that yield a cephalic presentation,it is typically done around 37 weeks of pregnancy.before 36 weeks of pregnancy ,there is a chance to rotate to head down position on its own ,after 38 weeks of pregnancy moving is difficult ,that's why 37 weeks is the recommended time and improves the chances of having a vaginal birth.ECV reduces the rate of non-cephalic presentation at birth and success rate is 50 to 60 percent[1]. Aims And Objectives: To evaluate the external cephalic version (ECV) procedure for the management of at term breech presenting foetus[2]. Inclusive Criteria: 1. Term with malpresentation 2. Abundant amniotic fluid 3. Unengaged presenting part 4. Non Anterior placenta 5. Multiparity 6. Non obese patient 7. Viable foetus 8. No previous cesarean scar Exclusive Crietria 1. Placenta previa 2. Early labour 3. Oligohydrominos 4. Ruptured membranes 5. Structural Uterine abnormalities 6. Foetal growth restrictions 7. Multi foetal gestation 8. Uterine incision 9. Hyper extended head Methods- Source for this study: In this prospective, interventional study, 10 patients with uncomplicated breech presentations at 37 weeks' gestation were considered for ECV. This was performed in our teaching hospital between January 2023 and December 2023.The main outcome measure was assessed as the success rate of ECV attempt and the rate of cesarean section following a successful procedure. Parity,abundant amniotic fluid, type of breech, placental location,and birth weight were evaluated as predictors of success.Also,any fetal or maternal complications during the procedure were evaluated. Results In our study, The success rate was 60%. The rate of cesarean section following successful procedure was only 10% and emergency cesarean section performed in 10%. Prognostic parameters associated with successful ECV were multi parity and flexed type of breech. There were no serious fetal or maternal complications associated with the attempt. ConclusionWith appropriate selection of patients,ECV is highly successful and is a safer alternative to vaginal breech delivery or cesarean delivery.Advice: ECV should be usually performed in center where an all the emergency facilities and operating facilities available.You need to monitor to ensure that patient is not in labour and baby is not in distress.