External cephalic version In Breech Babies

What is a breech baby?

A baby whose feet are lying on the lower part of the uterus instead of the head.

What chances are that my baby can be in a breech position?

3-4 %

When should we be worried about this position?

Before 34-36 weeks the baby keeps moving hence the breech position is not considered permanent. After 36 weeks if the baby is head up it is considered permanent. There is nothing to be worried about; it’s just a position in which the baby is comfortable.

Causes of a breech position in the baby?

Low lying placenta, twin pregnancy, common in first pregnancies, too much or too little fluid around the baby.

What if my baby is breech at term?

Your doctor will plan a caesarean section or if the facility is available to do an external cephalic version (trying to turn your baby)

What is External Cephalic Version (ECV)?

It is the transabdominal manual rotation of the fetus into a cephalic presentation.

How is ECV performed?

A hospital where a radiology facility, along with a trained gynaecologist and a facility for emergency caesarean section is available your doctor will plan the procedure after discussing with you all pro and cons. She will take proper consent. If you are less than 39 weeks after ECV you will be called at 39 weeks to confirm the position of the baby. If your baby is still head low you will be left for spontaneous labour or induced as per indication. If you are 39 weeks and the baby is still breech you will be taken for ECV in OT, after the procedure if your baby is still breech you will be taken up for Caesarean.

Benefits of ECV: You have a chance of delivering vaginally.

What to expect when I go for ECV?

Chances of an emergency caesarean section are there if the heartbeat of the baby dips during or after the procedure. During labour there are chances that you land up having an emergency caesarean section, forceps, or vacuum delivery. There are chances of having fetal distress and bleeding from the placenta. There may be a chance that your baby changes its position again to breech after ECV in a few days or the process can be unsuccessful at the first attempt only.

When should ECV not be done?

If you have multiple pregnancies; if you have leaking; if you have had a vaginal bleed; abnormal CTG

Percentage success rate: 50%

Is there anything else I can do to turn my baby?

There are other exercises that help your baby to change position; Moxibustion; acupressure. All to be done under trained personnel only.

Can’t I opt for a vaginal breech delivery? Yes, you can, but you will have to sign a risk that there are chances of your baby having complications during labour and delivery.

What if I have a twin pregnancy and one baby is breech?

If your first baby is breech and the second is cephalic. Your doctor will advise a caesarean section. If your first baby is a cephalic and second breach, you can go for normal delivery, because after the 1 st baby which is head down comes out the second breach can come out easily even if breech.

ECV is a safe alternative to vaginal breech delivery or caesarean delivery, reducing the caesarean delivery rate for breach by 50 %.


 

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