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)