Anesthesia Considerations 

External Cephalic Version 

 

 

Considerations

 

• Pregnancy considerations (difficult intubation, aspiration, ↓ time to desaturation, aortocaval compression, 2 patients)

• Must have continuous FHR monitoring during procedure 

• Complications (although uncommon) associated with the procedure:

  • Transient & persistent FHR abnormalities 

  • Vaginal bleeding 

  • Placental abruption 

  • Fetomaternal hemorrhage (+ Kleihauer-Betke test) 

• Potential need for STAT delivery (have personnel, equipment, OR available) 

• Mode of anaesthesia (controversial):

  • Have full discussion with obstetrician & patient 

  • Some evidence that neuraxial may ↑ success rates 

  • Options: no anesthetic, IV analgesia, neuraxial (low vs high dose)