What Is External Cephalic Version? How Is It Done?

Thursday, September 6, 2018, 15:13

Most babies are born in a head-first position. Babies, who usually move about, turn and make all kinds of motions in the womb, calm down and take up a head-down position by the 36th week. This is an important precursor to the labour and delivery.

But sometimes, a baby fails to assume the head-down position which is most favorable for a natural birth. If such cases go unnoticed and untreated, it may lead to complicated births and may even need a Caesarean section for the delivery.

Fortunately, there are ways in which the baby can safely be turned to help it get into a head-first position. One of these methods is known as External Cephalic Version (ECV). In this method, the baby is 'nudged' into position by the doctor manually.

Today, we shall take a look at what ECV is. We shall also go on to consider the risks involved. Read on to know more.

What Is ECV?

There are many babies that may still be in a ‘breech position' by the time they are in their 36th week of pregnancy. Such babies are in a position which will have either their feet or their bottoms come out first if they go on to have a vaginal birth. This will make the birth difficult and complicated.

If breech cases are found out early enough and the pregnancy is not considered high risk, the doctors may suggest ECV. In this procedure, the doctors will use gentle pressure on the abdomen to make the baby get into the correct position for birth.

What Should You Expect During The Procedure?

This procedure is very safe and is not invasive. Firstly, the baby will be monitored and his heartbeat will be constantly watched for signs of distress. The CTG or the cardiotocograph will be used for this. The baby will be monitored for half an hour before the procedure even begins. You may be administered some medicines that will help the uterine muscles relax. This won't harm you or the baby.

Next, the doctor will place his hands on the surface of your stomach. With gentle pressure, the doctor will try to turn your baby or coax him into turning into the correct position. Once the doctor is assured that the baby is correctly positioned, he will use the ultrasound to check and make sure. The ultrasound can also be used by your doctor to guide him while performing the procedure.

Is The Procedure Painful?

If you are given a drug to relax your uterus muscles, you may feel a slight discomfort. The pressure applied by the doctor on the abdomen may also feel uncomfortable. As the pain threshold for each person differs, you may expect anything from a slight discomfort to a slight pain during the procedure.

What Are The Risks Of Going Through ECV?

There are many things you should consider when deciding whether or not to undergo an ECV.

• You should not go for ECV if you are carrying twins or multiples.
• You should not choose ECV if you are going to get a cesarean section due to medical reasons anyway.
• If you have a womb that is heart-shaped or is a bicornuate uterus, you should not go for ECV as it has fewer chances of success. A pear-shaped womb is most suited for this procedure.
• If you have vaginal bleeding in a week before the procedure do not go for ECV.
• If your baby's heartbeat seems abnormal, do not go for ECV.
• If you or your baby has health conditions that may be a deterrent to the procedure, do not choose ECV.
• If your water has already broken do not undergo ECV.

How Safe Is The Procedure?

ECV is very safe in most cases. But in some cases, it has been seen that the baby's heart rate changes during the procedure. Other complications you may need to be prepared for are the detachment or tearing of the placenta and preterm birth.

In most hospitals, the procedure is done in controlled conditions which facilitate an emergency Caesarean section if the need arises.

When you get back home after the procedure, look out for bleeding, abnormal contractions and a lack of movement in your baby. If any of these things are noticed, contact your doctor immediately.

What Is The Success Rate Of The ECV Procedure?

More than 50 per cent of the babies that undergo the ECV go on to have normal and healthy vaginal deliveries. But less than half of the babies may also go back into a breech position. This is because the babies will continue to move in the womb even after the procedure is done.

What Can Be Done If The ECV Was A Failure?

Most ECV procedures get the babies into the right position. But if the procedure failed and the baby does not turn in the first attempt, your doctor may want to try again in another week. Most babies stay in position once turned as they are big and have very less space to move around. But sometimes the babies flip into a breech position after the procedure.

You may choose not to go for a second attempt as the baby may flip into the correct position when the birth comes near. If it does not happen, a vaginal birth may still be possible or you may even choose a Caesarean section.