Medical use[ edit ] ECV is one option of intervention should a breech position of a baby be found after 36 weeks gestation. Other options include a planned caesarian section or planned vaginal delivery. In addition, the effect of neuraxial blockade on ECV success rates have been conflicting, although ECV appears easier to perform under epidural block. These include recent antepartum haemorrhage , placenta praevia , abnormal fetal monitoring, ruptured membranes , multiple pregnancy , pre-eclampsia , reduced amniotic fluid and some other abnormalities of the uterus or baby. An ultrasound to estimate a sufficient amount of amniotic fluid and monitoring of the fetus immediately after the procedure can also help minimize risks. The Cochrane review concluded that "large observational studies suggest that complications are rare".
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Submit Internal podalic version and breech extraction Breech extraction describes the emergency procedure that is undertaken in order to expedite birth with a breech presentation. Rarely, it may be required when there is severe fetal distress during the second stage of labour with a breech presentation.
It is occasionally required during birth of multiple pregnancy when there are problems with the delivery of a second twin because of fetal distress or an abnormal fetal lie. In these circumstances, internal podalic version will be required prior to breech extraction. The fetal foot should then be grasped and pulled gently and continuously into the birth canal.
If possible both fetal feet should be identified and grasped. Internal podalic version is easiest when there is a transverse lie with the fetal back superior or posterior. If the fetal back is inferior or if the limbs are not immediately palpable, then ultrasound may be used to locate the fetal limbs.
As it is an emergency manoeuvre, the rest of the breech birth is undertaken with a combination of the techniques described earlier to deliver the lower limbs and trunks, shoulder and arms and the aftercoming head. There is a high risk of injury to the mother and fetus and a contemporaneous documentation and de-briefing of the couple is essential.
External cephalic version
Internal podalic version and breech extraction