Re: external cephalic version
From: Jim Connerth (babydoc@apex.net)
Sat Apr 29 23:13:15 2000
Ahh-good question! Has it been established that maternal oxygen is beneficial
to fetal unit?
Ronnie Martinez Brignardello wrote:
> 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
