WOMENS-HEALTH Messages for April, 1997: Re: External Cephalic Version

Re: External Cephalic Version

From: Roberta (anonymous@obgyn.net)
Sat, 12 Apr 1997 15:13:31 -0500 (CDT)

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At Sat, 12 Apr 1997, Marion wrote: >
>I will be 37 weeks pregnant this Tuesday, the 15th, and because my baby
>is currently in a breech position, I am scheduled for external cephalic
>version on Wednesday. Can anyone give me any information on this
>procedure? I have heard that it is only about 50% effective with first
>time pregnancies, and that soemtimes it can induce early labor. Please
>advise as soon as possible. Thank you very much.

I foun this on the Internet:

Dear Peg,

My wife is currently in her 37th week and the baby is in the breech position. We have an appointment next week to talk with a high risk doctor concerning fetal rotation. Is this procedure safe? Would she be better off simply having a c-section?

Please let me know your thoughts.

The Midwife Answers:

Dear Steve,

You are wise to question any procedure offered to you and your family. In this case, however, the benefits of external cephalic version will probably outweigh the risks.

Renewed interest has occurred in the past 20 years in turning breech babies. They used to do this a lot, but many babies and some mothers died due to ruptured uterus or cord accidents. Now that we have monitoring available and the use of ultrasound and drugs to relax the uterus, it has become a safe procedure in the hands of an experienced midwife or obstetrician.

Your wife should have an ultrasound immediately before and intermittently during the version. Some babies are not good candidates for version because of the way they are situated. She will be monitored before and after to assure that the baby is not undergoing undue stress. A medication such as Terbutaline will be administered to relax the uterus and then the doctor and an assistant will grasp the head and the buttocks and turn the baby in a somersault.

The risks of C-birth are higher than this procedure and a version reduces the rate of C-birth by about 30-40%. About 70% are successful, some turn back and some cannot be performed at all due to difficulty encountered. A baby is never forced to turn. It is done only if it can be done easily - although watching the procedure it sometimes does not seem very gentle. The mother will feel a significant amount of pressure.

Don't be afraid to question the physician on his stats and experience.

If this version fails, there are some breech exercises your wife can do. 15 minutes twice to three times a day, midwives recommend elevating the buttocks (lying on a collapsed ironing board works well). Maintaining a knee-chest position has also been found effective. Kneel on the floor and then rest 5-10 minutes with your head on your hands - buttocks in the air. This should be done only to mother's tolerance. If she gets dizzy or light headed or nauseated, she should stop.

Best of luck.

Peg

Answer courtesy of Peg Plumbo, CNM

--
Roberta Speyer
President and CEO
Elecomm Corporation
Founders of OBGYN.net

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