External Cephalic Version Treatment

What is External Cephalic Version?

When the woman is pregnant, long before she felt that first fluttery kick, the baby has been moving and grooving all over her womb. These usually keep up until the 36-week mark, when most of the babies strike their final pose. They get into a headfirst or cephalic position toward the opening of the birth canal. But sometimes 4% of the babies come out with bottom or feet first. This makes vaginal birth difficult. The doctor may suggest turning the baby into the headfirst position with a procedure called an external cephalic version. The external cephalic version is a manual process by which a breech baby can be turned from foot or buttocks first to head first. It is generally done late in pregnancy, i.e., after 36 gestational weeks, but preferably 37 weeks, and can be performed even in the early labor. External cephalic Version is different from the "internal cephalic version", which involves insertion of a hand through the cervix.

Are There Reasons to Avoid an ECV?

An ECV is not required by everyone if the patient is expecting more than one baby at a time or if the patient needs a C-section for other health reasons. It is best for those women who have a pear-shaped womb and not with a heart-shaped womb, called a bicornuate uterus.

Other reasons the doctor might tell the mother not to get an ECV are:​

Free Consultation on WhatsApp

• If the patient has vaginal bleeding within 7 days of the procedure.
• If the baby has an abnormal heartbeat or health problems.
• If the patient’s water has broken.

Who cannot have an ECV?

External Cephalic Version is not recommended to those patients, who have:

• a complicated pregnancy
• twins or triplets
• an unusually shaped uterus
• had a cesarean section before
• recently had vaginal bleeding
• low levels of amniotic fluid
• placenta praevia 
• other health conditions can also hinder ECV, like high blood pressure or diabetes

ECV might also not be recommended if the unborn baby is unwell or is not growing well.

Need for an External Cephalic Version Treatment

External Cephalic Version (ECV) surgery is recommended for women in their third trimester if the baby is positioned breech or transverse and can push the head close to or towards the cervix. Why ECV Might Be Recommended:

• Improving Chances for Vaginal Delivery
• Reducing Cesarean-Related Risks
• Safety for Baby
• Symptoms Leading to an External Cephalic Version Treatment
• Here are the key signs and symptoms that can lead a healthcare provider to recommend ECV treatment:
• Breech or Transverse Fetal Position
• Non-Head-Down Position Felt by the Mother
• Late Pregnancy Symptoms Indicating a need for Position Change
• Previous Breech Birth History

What are the risks involved?

With frequent monitoring, the risks of the external cephalic version to the mother and her fetus are quite low.

Potential risks of ECV, for which the fetus and mother are closely monitored, may include:

• Twisting or squeezing of the umbilical cord, reducing blood flow and flow of the oxygen to the fetus.
• The beginning of labor, which can be caused due to the rupture of the amniotic sac around the fetus
• Rupture of the uterus, placenta abruption, or damage to the umbilical cord.

In the rarest of cases, the labor begins or the fetus or mother develops a serious problem during version, an emergency cesarean section may be performed for delivering the fetus.

ECV has a small risk for causing bleeding that can result in the mixture of the blood of the mother and fetus. So a pregnant woman with Rh-negative blood is given an Rh immunoglobulin injection for preventing Rh sensitization, which can cause complications with the fetus in the future pregnancies. 

Causes Leading to an External Cephalic Version Treatment

Breech and transverse position in a baby anticipating a birth requires an ECV. These causes are mainly related to uterine factors or factors that interfere with fetal activity within the uterus. Here are common causes that may lead to the consideration of ECV:

• Uterine Shape and Structure
• Excess or Low Amniotic Fluid
• Multiple Pregnancy
• Placental Location
• Premature Delivery
• Previous Pregnancies
• Fetal Conditions
• Short Umbilical Cord
• Intrauterine Growth Restriction
• Previous Breech Delivery or Breech History

Facilities and Services offered for International Patients for an External Cephalic Version Treatment 

Now regarding External Cephalic Version (ECV), most of the hospitals and healthcare centres offer international patients care services and facilities with ease. Such centres are magnificently halted with stream of medical equipments, skilled professionals, and procedural care taking services to fulfil the safety measures of international patients.

• Personalized Care Coordination
• Medical Consultations and Diagnostic Services
• World-Class Medical Facilities and Experienced Practitioners
• 24/7 Emergency Care and Safety Protocols
• Accommodation and Travel Assistance
• Post-Treatment Care and Follow-up Support

Free Consultation on WhatsApp

How is an ECV performed?

An obstetrician puts their hands on the patient’s abdomen to turn their baby into a head-down position. A cardiotocograph or CTG will help in monitoring the baby’s wellbeing for 20-30 minutes before the procedure. A small needle will be inserted into the mother hand for relaxing their uterus. An obstetrician will then perform an ultrasound to know the position of the baby and will attempt to turn the baby by pressing their hands firmly on the abdomen. Some women may find this uncomfortable. The pressure on the abdomen only lasts for a few minutes. If the first attempt is unsuccessful, the obstetrician might try it again. The CTG might be applied again after the procedure to assess the baby’s wellbeing. It generally takes up to 3 hours.

How It Works?

He baby's heartbeat will be monitored regularly with a cardiotocograph for about a half-hour before the ECV. In some of the cases, the patient may be given medicine through an IV for relaxing their uterus. This will not affect the baby. Then, by pressing her hands on the outside of the belly, the doctor will try to turn their baby. The goal is to get the baby to do a little flip in the womb and the baby will end up with head-down. The doctor may use an ultrasound to check their baby's position and guide the process.

Does It Hurt?

To turn the baby, the doctor will use a good amount of firm pressure. Every patient reacts differently, so they might feel discomfort or pain during this process.

Post-Treatment Process for External Cephalic Version 

The after-care process for ECV includes examination of the mother and fetus for adverse effects that might arise from the procedure and additional directives which a woman should adhere to.

Here’s an outline of what the post-treatment process typically entails:

• Immediate Monitoring
• Observation Period
• Ultrasound Check
• Discharge Instructions
• Emotional Support and Counselling
• Remote or Virtual Follow-up
• Ongoing Monitoring of Baby’s Position

Success rates

ECV has a success rate of 75%. Various factors can affect the success rates of ECV. Maternal weight, practitioner experience, obstetric factors such as a palpable fetal head, uterine relaxation, non-anterior placenta, a non-engaged breech, and an amniotic fluid index above 7–10 cm, are the factors which can be associated with higher success rates during ECV. In addition, the effect of neuraxial blockade on ECV success rates has been conflicting, although ECV is easier to perform under the epidural block.

With the successful ECV, the baby head is turned; there is a less than 5% chance for the baby to turn spontaneously to breech again.

Other methods to potentially turn my baby from a breech position

Some people think that the mother might be able to encourage their baby to turn by holding herself in certain positions, such as kneeling with their bottom in the air and held their head and shoulders flat to the ground. Other alternatives may include acupuncture, a Chinese herb called moxibustion and chiropractic treatment, there is no good evidence that these work. The patient must discuss every possible option with their doctor or midwife before undergoing any treatment during pregnancy.

Best Hospitals for External Cephalic Version Treatment

• Fortis Memorial Research Institute, Gurgaon
• Medanta The Medicity, Gurgaon
• Artemis Hospital, Gurgaon
• Max Hospital, Saket, New Delhi
• Apollo Hospital, New Delhi

Best Doctors for External Cephalic Version Treatment

• Dr. Mamta Pattnayak
• Dr. Preeti Rastogi
• Dr. Renu Raina Sehgal
• Dr. Anuradha Kapur
• Dr. Madhu Roy

Why Choose GetWellGo for External Cephalic Version Treatment?

Decision to visit external cephalic version treatment at GetWellGo guarantees international patients to get an overall support with doctors, expertise and connection to high level hospitals.

Here’s why GetWellGo is a top choice for ECV:

• Expert Medical Team
• Advanced Diagnostic and Monitoring Technology
• Personalized patient Care
• Multilingual Support
• Travel and Accommodation Assistance
• Visa Assistance
• Transparent Pricing
• Post-Procedure and Follow-up Care
• High Success Rates

Conclusion

External Cephalic Version (ECV) is a technique of delivering babies where they lie in breech or transverse positions and turning them to lie vertically in order to enhance safe vaginal delivery. It is safe and produces good results but success depends on the size of the baby, amount of amniotic fluid, and the condition of the uterus. In order to confirm whether the treatments were efficient and to monitor the state of both mother and baby after the treatment, post-treatment is recommended. Depending on equipment and support services as well as technologies, the most reputable health facilities increase safety and successful outcomes.

FAQs

1. What are the benefits of ECV?

• Most mothers desiring a vaginal birth would benefit from ECV because it positions the baby, head down, thereby making a C-section less likely. This process is less invasive and requires little time to heal, has few postpartum complications while having fewer complications in subsequent pregnancies than Cesarean section.

2. How successful is ECV?

• Success rates of ECV range between 50-60% for first-time mothers and slightly higher, between 60-70% for women who have given birth before. It may take simple things like the position of the baby, amount of this amniotic fluid, and even the practitioner to determine success.

3. What is the Recovery time after ECV?

• Fortunately, ECV is not a surgical procedure, and most often, full recovery takes a short time. The majority of the women can go on their work the very next day but they may be advised to take a little break after the procedure. Minimal discomfort and possible stomach grumbling are likely, although these symptoms should disappear in a day or so.

Free Consultation on WhatsApp