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External cephalic version (ECV)
Turning a breech baby to cephalic through the abdomen.
Source: RCOG GTG 20aKey facts
| When | From 36+0 wk (nullip), 37+0 wk (parous). |
|---|---|
| Success | ~50% overall (~40% nullip, ~60% parous). |
| Risk | Emergency CS within 24 h ~1 in 200. |
Technique
- CTG and scan (breech type, back, placenta, liquor).
- Tocolysis: terbutaline 250 micrograms SC.
- Lift breech out of pelvis; keep head flexed.
- Forward roll first; backward flip if it fails.
- Max ~10 min, checking fetal heart intermittently.
- CTG afterwards; anti-D if RhD-negative.
Contraindicated: CS needed anyway, APH, major praevia, multiple pregnancy (except 2nd twin), uterine anomaly.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.