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

Re: External Cephalic Version

From: R.Daniel Braun, MD (anonymous@obgyn.net)
Tue, 15 Apr 1997 08:24:44 -0500 (CDT)

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At Sat, 12 Apr 1997, Dr wrote: >
>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.
>
>--
>
>Marion,
>
>ECV is (most of time) an outpatient procedure, with or without
>anesthesia. The aim is to verse the baby in a more convenient position
>for the delivery. More convenient for the medical professionals I mean.
>If it doesn't work your doctor will decide if he will perform a cesarean
>section or not, depending on your own case. It can induce labor too,
>that's why ECV is always peformed when the baby is mature, which your
>case.
>Have a good end of your pregnancy and a good delivery.
>
>--
>Bernard Cristalli MD CNGOF
>Paris - France
>http://www.obgyn.net/corresp/cristalli.htm
>

Dr. Cristalli's perspective is slightly diferent from that of mos U.S. physicians. Most of us feel that anesthesia should not be used for ECV(External Cephalic Version). Most people who do ECV usually use Terbutaline or some other agent to relax the uterus and to keep it from contracting during the procedure. The success rate varies with the time in pregnancy at which the procedure is done and the experience of the operator. Success rates have been reported as low as 30% and as high as 93%. Most recent reports are in the 60-70% range. A key factor is that the procedure should be done very close to an available cesarean section room so that if trouble should occur, the baby could be delivered by cesarean within 10-15 minutes. Those problems are cord entanglement, separation of the placenta, and rupture of the uterus. All of these together will occur in maybe 1/300-400 atteempts. but we cannot predict which ones. I hope all goes well for you tomorrow.

--
R.Daniel Braun, MD  FACOG
Clinical Professor of Obstetrics and Gynecology
Indiana University School of Medicine
Indianapolis, IN
                                      "Heisenberg might have slept here."
                                          Unknown or maybe Indecisive                                               Unknown

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