External Cephalic Version
Publication Date: May 2, 2020
Last Updated: March 14, 2022
Summary of Recommendations
Because the risk of an adverse event occurring as a result of ECV is small and the cesarean birth rate is significantly lower among women who have undergone successful ECV, all women who are near term with breech presentations should be offered an ECV attempt if there are no contraindications. (A)
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Fetal presentation should be assessed and documented beginning at 36 0/7 weeks of gestation to allow for ECV. (B)
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Evidence supports the use of parenteral tocolysis to improve the success of ECV. (B)
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Neuraxial analgesia in combination with tocolytic therapy can be considered a reasonable intervention to increase ECV success rate.
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Fetal well-being and contraction pattern should be assessed by a nonstress test or biophysical profile before and after the procedure. (C)
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External cephalic version should be attempted only in settings in which cesarean delivery services are readily available. (C)
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Recommendation Grading
Disclaimer
Overview
Title
External Cephalic Version
Authoring Organization
American College of Obstetricians and Gynecologists
Publication Month/Year
May 2, 2020
Last Updated Month/Year
July 10, 2023
Document Type
Consensus
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Adult
Health Care Settings
Ambulatory, Hospital, Operating and recovery room
Intended Users
Nurse midwife, nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Management
Diseases/Conditions (MeSH)
D001946 - Breech Presentation
Keywords
cesarean delivery, breech, cesarean, external cephalic version, vaginal breech delivery