OBGYN Associates, PA

External Cephalic Version

Under typical circumstances, babies are born head first. Throughout the pregnancy the fetus changes positions, but as the pregnancy approaches the 36 -38 week mark, a baby usually will assume the correct “head down” birthing position.

On occasion, the baby fails to turn head down. When the baby is bottom first, the term “breech” is used. About 4% of deliveries are breech. Risk factors for a breech presentation include prematurity, uterine malformation, placenta previa, and twin pregnancy.

Vaginal delivery of a breech presentation is considered dangerous for the baby. When the baby is breech during labor, there is a risk that the umbilical cord will prolapse between the baby’s legs which compromise oxygen delivery to the baby. As a result, cesarean delivery is recommended for breech presentation during labor.

In an attempt to avoid cesarean delivery, the obstetrician may recommend a procedure to convert the baby from a bottom first to a head first presentation. This procedure is called external cephalic version (ECV) or more simply, “version”.

Version is usually performed in a hospital setting and is frequently performed with epidural anesthesia and is often scheduled at about 36 weeks of pregnancy. Under ultrasound guidance, the obstetrician uses manual pressure to manipulate the baby into a head down position. ECV is successful in 50-60% of the time.

Like most procedures, version has risks. There is a risk of labor, emergent delivery by cesarean section, and failure for the procedure to work.

A breech version is a low risk procedure that is best used on an otherwise trouble-free pregnancy. Your doctor will help you to understand the need for the procedure, your eligibility, and the possible risks.

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