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External Cephalic Version
Description
External cephalic version is the process used to move a malpositioned fetus into the vertex position by external means. This is performed on the nonlaboring patient near term (≥37 0/7 weeks) to improve the chance of vaginal delivery.
Indications
Fetal malposition, oblique or most often breech.
Contraindications
External cephalic version is contraindicated anytime vaginal delivery is not clinically appropriate. Additional contraindications include nonreassuring fetal heart tones, known fetal or uterine anomalies, multiple gestation, hyperextension of the fetal head, macrosomia, placenta previa, prior uterine vertical scar, ruptured membranes, oligohydramnios, engaged fetal part, and maternal obesity sufficient to impede the palpation of the fetus. Known or suspected allergy to agents used (eg, latex, coupling gel), uncorrected coagulopathy. The success of external version is less when there is an anterior placenta and is often seen as a relative contraindication.
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