Wilcox CB, Nassar N, Roberts CL (2011) Effectiveness of nifedipine tocolysis to facilitate external cephalic version: a systematic review. the fetal axis crosses the maternal axis at an angle other than a right angle, i.e. Alarab M, Regan C, O’Connell MP et al (2004) Singleton vaginal breech delivery at term: still a safe option. Grootscholten K, Kok M, Oei SG et al (2008) External cephalic version-related risks: a meta-analysis. Obeidat N, Lataifeh I, Al-Khateeb M et al (2011) Factors associated with the success of external cephalic version (ECV) of breech presentation at term. The information provided herein should not be used for diagnosis or treatment of any medical condition. Very rarely, the head is retained above the pelvic brim, the neck greatly elongates, the breech descends followed by the trunk and the after -coming head, i.e. The use of tocolytics (uterine relaxants) to facilitate ECV has been shown to increase cephalic presentations (RR: 1.38; 95% CI: 1.03–1.85) and reduce the rate of caesarean sections (RR: 0.82; 95% CI: 0.71–0.94) in both nulliparous and multiparous women (Cluver et al 2012). Fundal level: lower than that corresponds to the period of amenorrhoea. Term Breech Trial Collaborative Group. Neri I, De Pace V, Venturini P et al (2007) Effects of three different stimulations (acupuncture, moxibustion, acupuncture plus moxibustion) of BL.67 acupoint at small toe on fetal behavior of breech presentation. membranes and cord prolapse. If you do not want to receive cookies van den Berg I, Bosch JL, Jacobs B et al (2008) Effectiveness of acupuncture-type interventions versus expectant management to correct breech presentation: a systematic review. Factors predicting successful ECV include posterior placental location, complete breech position, amniotic fluid index >10, unengaged presenting part, maternal weight <65 kg and thicker fundal myometrium on ultrasound (Hutton et al 2008; Kok et al 2008b; Kok et al 2009; Buhimschi et al 2011; Burgos et al 2011; Obeidat et al 2011; Bogner et al 2012; Burgos et al 2012; Cho et al 2012). Buhimschi CS, Buhimschi IA, Wehrum MJ et al (2011) Ultrasonographic evaluation of myometrial thickness and prediction of a successful external cephalic version. When the cervix is sufficiently dilated particularly after rupture of the membranes, the scapula, acromion, clavicle, ribs and axilla can be felt. Both the presentation and the position of the fetus in the uterus may be wrong and correct. In addition to the previous findings, vaginal examination reveals: As a rule no mechanism of labour should be anticipated in transverse lie and labour is obstructed. The abdomen is broader from side to side. Small studies have shown that the moderate degree of pain associated with ECV is well tolerated by the majority of women because of its short duration (Fok et al 2005) and that most women rate ECV as a good experience, whether it is successful (94%) or unsuccessful (71%) (Rijnders et al 2010). After correcting the foetal lie to longitudinal, apply an abdominal binder, start oxytocin infusion and do amniotomy when the uterine contractions started and the presenting part is well settled into the pelvic brim. Comments (6) Harvey80. Basic Definition • Lie – Relationship between long axis of fetus and long axis of uterus • Presentation- Part of the fetus that presents to the maternal pelvis 16. Demirci O, Tugrul AS, Turgut A et al (2012) Pregnancy outcomes by mode of delivery among breech births. Hopkins LM, Esakoff T, Noah MS et al (2007) Outcomes associated with cesarean section versus vaginal breech delivery at a university hospital. no fetal presenting part is palpable in the lower pole and the head or the breech spontaneous version occurs in the pelvic cavity. External cephalic version should be performed by a health professional with appropriate expertise. so that we can recognise you and provide you with the best service. contained herein is strictly prohibited. Clinical picture (impending rupture uterus). 32nd week of pregnancy. Sibony O, Luton D, Oury J-F et al (2003) Six hundred and ten breech versus 12,405 cephalic deliveries at term: is there any difference in the neonatal outcome? In early labour, if version succeeded apply abdominal binder and rupture the membranes as if there are uterine contractions. Some do it selectively in cases discovered after 40 weeks’ gestation. Copyright 2020 Oxbridge Solutions Ltd®. change the shape of pelvis, uterus or foetus. longitudinal axis of the fetus straddles across the horizontal axis of the uterus, in an oblique lie there is an anatomical relationship in which Among women who gave birth in Australia in 2010, most fetal presentations were vertex (94.4%). My midwife and doula said I had a great pelvis for birthing. conditions. is in an iliac fossa. Nor Azlin MI, Haliza H, Mahdy ZA et al (2005) Tocolysis in term breech external cephalic version. In Australia, it is recommended that all health professionals providing antenatal care be experienced in palpation of the pregnant abdomen including identification of the presenting part (RANZCOG 2009). Weavernest. Anybody is having oblique lie of presentation. GPnotebook stores small data files on your computer called cookies Relative contraindications for external cephalic version include a previous caesarean section, uterine anomaly, vaginal bleeding, ruptured membranes or labour, oligohydramnios, placenta praevia and fetal anomalies or compromise. So, maybe I’m just being paranoid. is an indication for caesarian section. Hutton EK, Saunders CA, Tu M et al (2008) Factors associated with a successful external cephalic version in the early ECV trial. A classical or low vertical incision in the uterus facilitates extraction of the foetus as a breech in such a condition. Page . Approved by NHMRC in June 2014; expires June 2019. Geneva Foundation for Medical Education and Research, Obstetrics Simplified - Diaa M. EI-Mowafi, Shoulder Presentation (Transverse or Oblique lie). Aboriginal and Torres Strait Islander Health Practitioner, Aboriginal and Torres Strait Islander Health Worker. year = mdate.getYear(); Doyle NM, Riggs JW, Ramin SM et al (2005) Outcomes of term vaginal breech delivery. Cephalic presentation: head (most common) management of an oblique lie are similar to those for a transverse lie, in In an oblique lie, generally no palpable fetal part is presenting. Krebs L & Langhoff-Roos J (2003) Elective cesarean delivery for term breech. Umbilical grip: The head is felt on one side while the breech one the other. Abnormal lie 18. Guideline no. Rijnders M, Offerhaus P, van Dommelen P et al (2010) Prevalence, outcome, and women’s experiences of external cephalic version in a low-risk population. While the positive effects of abdominal palpation are difficult to quantify, no risks have been identified and it provides a point of engagement with the mother and baby. a transverse lie there is an anatomical relationship in which the long axis of Jadoon S, Khan Jadoon SM, Shah R (2008) Maternal and neonatal complications in term breech delivered vaginally. Oxbridge Solutions Ltd® receives funding from advertising but The oblique lie which is deviation of the head or the breech to one iliac fossa, is less hazardous as correction to a longitudinal lie is more feasible. Incidence. Uotila J, Tuimala R, Kirkinen P (2005) Good perinatal outcome in selective vaginal breech delivery at term. Multiparae with a lax uterus and abdominal wall. © Commonwealth of Australia | Department of Health. The oblique lie which is deviation of the head or the breech to one iliac fossa, is less hazardous as correction to a longitudinal lie is more feasible. The reported success rate of ECV is in the range of 36.7–72.3% (Hutton et al 2003; Fok et al 2005; Nor Azlin et al 2005; Nassar et al 2006; El-Toukhy et al 2007; Weiniger et al 2007; Grootscholten et al 2008; Kok et al 2008c; Rijnders et al 2010; Buhimschi et al 2011; Burgos et al 2011; Gottvall & Ginstman 2011; Obeidat et al 2011; Bogner et al 2012; Cho et al 2012; Cluver et al 2012). Burgos J, Melchor JC, Pijoan JI et al (2011) A prospective study of the factors associated with the success rate of external cephalic version for breech presentation at term. 3. of . Malpresentations included breech (3.9%), face or brow presentation (0.2%) and shoulder/transverse and compound presentations (0.7%) (Li et al 2012). Posted 12/02/2020. A transverse A small non-randomised study suggested that clinical hypnosis combined with tocolysis before ECV may increase success rates (Reinhard et al 2012). In a systematic review, the most frequently reported complications of ECV were transient abnormal cardiotocography patterns (5.7%), persisting pathological cardiotocography (0.37%), vaginal bleeding (0.47%) and placental abruption (0.12%) (Collaris & Oei 2004). Habek D, Cerkez Habek J, Jagust M (2003) Acupuncture conversion of fetal breech presentation. It is the best and safest method of management in nearly all cases of persistent transverse or oblique lie even if the baby is dead. Rarely the foetal lie may be corrected by the splinting effect of the contracted uterine muscles so that the head presents. please do not use GPnotebook. Weiniger CF, Ginosar Y, Elchalal U et al (2007) External cephalic version for breech presentation with or without spinal analgesia in nulliparous women at term: a randomized controlled trial. This lie is usually transitory and occurs as the baby is moving. date = mdate.getDate(); Kok M, Van Der Steeg JW, Mol BW et al (2008c) Which factors play a role in clinical decision-making in external cephalic version? Kumari AS & Grundsell H (2004) Mode of delivery for breech presentation in grandmultiparous women. Daskalakis G, Anastasakis E, Papantoniou N et al (2007) Cesarean vs. vaginal birth for term breech presentation in 2 different study periods. the Successful ECV reduces the rate of caesarean sections, with vaginal birth following ECV being successful in 71–84% of women (El-Toukhy et al 2007; Buhimschi et al 2011; Gottvall & Ginstman 2011; Bogner et al 2012; Reinhard et al 2013). maintains editorial independence. mdate = new Date (document.lastModified); Hi all. The foetus is severely distressed or dead. Yes over here. Posted 12/02/2020. Reinhard J, Heinrich TM, Reitter A et al (2012) Clinical hypnosis before external cephalic version.

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