The document describes the procedure of external cephalic version (ECV) to change the position of a fetus in breech presentation or transverse lie. It outlines the indications, necessary preparations, and the step-by-step process of the maneuver, emphasizing the need for monitoring and follow-up care. Additionally, it mentions precautions for rh-negative non-immunized women during the procedure.

1. VERSION

2. DEFINITION
It is a manipulative procedure designed to
change the lie or to bring the comparatively
favourable pole to the lower pole of the
uterus.
TYPES: According to the methods employed,

3. TYPES

4. EXTERNAL
CEPHALIC
VERSION

5. EXTERNAL CEPHALIC
VERSION

6. EXTERNAL CEPHALICVERSION
• External cephalicversion is done
to bring the favourable cephalic
pole in the lower pole of the
uterus Breech presentation

7. INDICATIONS
• Breecvh presentation
• Transverse lie
PROCEDURES
In breech presentation-The maneuver
is carried out after 35 weeks in the
labour-delivery complex.

8. • Any one of the following tocolytic drugs
(Terbutaline-0.25 mg S.C or Isoxsuprine 50-
100 µg IV)
• ultrasound examination is done to confirm the
diagnosis and adequacy of amniotic flood
volume.
• A reactive NST should precede the manoeuvre

9. • PRELIMINARIES:
• The patient is asked to empty her bladder.
• She is to lie on her back with the shoulders
slightly raised and the thighs slightly flexed.
• Abdomen is fully exposed.
• The presentation, position of the back and limbs
are checked
• FHR is auscultated.

10. ACTUAL STEPS
Forward somersault movement:
• Step-1: The breech is mobilised using both hands
to one iliac fossa towards which the back of the
fetus lies
• The podalic pole is grasped by the right hand in a
manner like that of Pawlik's grip while the head is
grasped by the left hand.

11. • Step-II: The pressure is now exerted to the
head and the breech in the opposite directions
to keep the trunk well flexed which facilitates
version. The pressure should be intermittent to
push the head down towards the pelvis and the
breech sowards the fundus until the lie
becomes transverse. The FHR is once more to
be checked.

12. ACTUAL STEPS

13. INSTRUCTIONS:
(1) The patient is advised for follow up to check
the corrected position
(2) To report if there is vaginal bleeding or
escape of liquor amnii or labour starts.
(3) Rh-negative non-immunised women must be
protected by intramuscular administration of
100 ug anti-D gamma globulin