Abstract
Presentation: A 35 year old woman, gravida 7 para 7, all vaginal deliveries, presented with labour pains at 39 weeks’ gestation with intact membranes. Cardiotocograph (CTG) was reassuring. Diagnosis: Breech presentation was confirmed by an ultrasound. Treatment: The patient was offered options of External Cephalic Version (ECV) versus (vs) Lower Segment Caesarean Section (LSCS). She opted for ECV which was successful, followed by controlled artificial rupture of membranes. She delivered a healthy baby girl vaginally and was discharged home on day 1 postpartum. Conclusion: Although intrapartum ECV is not recommended routinely, there is a place for its judicious use in selective cases. The prerequisites include an experienced obstetrician, reassuring CTG, previous vaginal delivery, no obstetric indication for performing LSCS, adequate amniotic fluid volume with intact membranes, early labour, and informed maternal consent. We recommend keeping theatre on standby while performing ECV in case an obstetric complication arises.
Highlights
The breech presentation is common in term pregnancies, there is no consensus on the suitable delivery option (ECV, breech delivery, and Lower Segment Caesarean Section (LSCS))
Conclusion: intrapartum External Cephalic Version (ECV) is not recommended routinely, there is a place for its judicious use in selective cases
The breech presentation is common in term pregnancies, there is no consensus on the suitable delivery option (ECV, breech delivery, and LSCS)
Summary
Intrapartum ECV is not recommended routinely, there is a place for its judicious use in selective cases. The prerequisites include an experienced obstetrician, reassuring CTG, previous vaginal delivery, no obstetric indication for performing LSCS, adequate amniotic fluid volume with intact membranes, early labour, and informed maternal consent. We recommend keeping theatre on standby while performing ECV in case an obstetric complication arises. Janjua NB, MRCOG (UK), M Sc (Distinction) Clinical Education (QUB, UK), Registrar, Department of Obstetrics and Gynecology, Wexford General Hospital, Co. Wexford, Ireland
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