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External cephalic version (ECV) Questions and Answers Grade A+ $9.99   Add to cart

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External cephalic version (ECV) Questions and Answers Grade A+

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External cephalic version (ECV) Questions and Answers Grade A+

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  • November 5, 2024
  • 7
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • ECV
  • ECV
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1|Page | © copyright 2024/2025 | Grade A+




External cephalic version (ECV)
Questions and Answers Grade A+
Background


✓ Breech presentation complicates 3-4% of all term deliveries and a

higher proportion of preterm deliveries. It is more common where there

has been a previous breech presentation.

✓ -ECV at term reduces the incidence of noncephalic presentation at

delivery . Spontaneous version rates for nulliparous women are

approximately 8% after 36 weeks, but less than 5% after unsuccessful

ECV; success rates of ECV are 30-80%. Spontaneous reversion to

breech presentation after successful ECV occurs in less than 5%.




What is the success rate of ECV and what influences it?




Master01 | October, 2024/2025 | Latest update

, 1|Page | © copyright 2024/2025 | Grade A+

✓ An overal success rate of 40% for nulliparous, and 60% for multiparous

women can usually be achieved. The highest success rates are seen

with multiparous, non-white women with a relaxed uterus, where the

breech is not engaged and the head is easily palpable. Success rates

are also higher with increasing liquor volume, but, in practice, very high

liquor volume may be associated with spontaneous reversion. Maternal

weight, placental position, gestation, fetal size and position of the legs

make less difference and are probably not independent of other

factors.

✓ -The use of tocolysis with beta-sympathomimetics may be offered to

women undergoing ECV as it has been shown to increase the success

rate.The use of tocolysis should be considered where an initial attempt

at ECV without tocolysis has failed. A simple protocol is to offer a slow

intravenous or subcutaneous bolus of salbutamol or terbutaline either

routinely or if an initial ECV attempt has failed. Women should be

advised of the adverse effects of tocolysis with beta-2 agonists.

✓ -Where ECV fails the possibility of a further attempt should be discussed.




Master01 | October, 2024/2025 | Latest update

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