Achieving Vertex Presentation of a Breech Fetus at or Near Term

Background

ACOG has confirmed and updated its guidance on external cephalic version (ECV) of a fetus in breech presentation fetus near term.

Key Points

The approach to ECV includes the following recommendations:

• Assess fetal presentation beginning at 36 weeks and 0 days' gestation.

• If malpresentation is detected, offer an ECV to be scheduled at 37 weeks and 0 days' gestation.

• Prior to initiating ECV, perform a nonstress test or biophysical profile to evaluate fetal well-being and uterine contraction pattern.

• Obtain informed consent after reviewing contraindications and benefits.

• Consider neuraxial anesthesia and administer a tocolytic prior to ECV.

• Before and after EC…