Re: external cephalic version
From: Ronnie Martinez Brignardello (ronniem@entelchile.net)
Sat Apr 29 20:09:05 2000
why oxygen?
ronnie
Steve & Eryl Raymond wrote:
> On 27 Apr 2000, at 21:35, Kevin D. Dew MD wrote:
>
> > 1. What gestational age?
> > 2. How soon afterward do you deliver?
> > 3. What do you use to relax the uterus?
> >
> > Trying to get an idea of what people are doing.
> >
> The WHO Reproductive Health Library states the following in a
> meta-analysis of trials involving ECV:
>
> Conclusions: There is compelling evidence that ECV attempt at
> term materially reduces the chance of non-cephalic birth and
> Caesarean section. The randomised trials to date are too small to
> address the question of the risk of ECV at term, though published
> uncontrolled series indicate that this is small. In individual cases,
> the risk of ECV needs to be weighed against the current and future
> risks of continued breech presentation to mother and fetus.
>
> As a result of reading this our policy has been established as
> follows:
> 1. Attempt ECV only if breech presentation at 37/40.
> 2. If unsuccessful then take to a CTG machine and give Ipradol
> 5mcg. (or another tocolytic) i.v. Within three to five minutes
> attempt ECV again.
> 3. Run CTG for five minutes if unsuccessful, 20 minutes if
> successful.
>
> My experience has been that a more than 50 % success rate can
> be achieved with this procedure. It is true that there are occasions
> where the procedure results in profound distress in the baby. You
> need to be ready to do a C/S if the FH doesn't respond to turning
> on the side and/or oxygen administration. This is excessively rare.
> Had to do it once in 20 years. Timing of delivery is no different then
> from your standard cephalic presentation.
>
> Steve Raymond
