8
NHS Forth Valley External Cephalic Version Patient Information
NHS Forth Valley
External Cephalic Version
Patient Information
Your Midwife or Doctor has discovered that your baby is lying in the breechposition (bottom coming first) and has recommended that you consider ourattempting to turn the baby into the head first position. This is called ExternalCephalic Version (ECV).
Why have I been given this leaflet?
An ECV involves the Doctor putting constant gentle pressure on your tummyto help the baby roll into the correct position.
What does an ECV involved?
2
Procedure for Turning the Baby
Figure 1: External Cephalic Version
1.The baby is in breechposition
2.The doctor feels for thebaby’s head and bottom
3.The doctor turns thebaby around
4.The baby is in positionfor normal delivery
The Royal College of Obstetricians & Gynaecologists (RCOG)(1) recommendthat we offer an ECV to all suitable women; however you can discuss your otheroptions with your Consultant. These involve either delivering the baby bycaesarean section, which would usually be our recommendation, or deliveringvaginally in the bottom first position. Alternative therapy methods toencourage the baby to turn (like reflexology) have not yet been proven to besuccessful and are therefore not routinely recommended by your Doctor.
Do I have to have this?
You will be offered an ECV when your baby is found to be in the breechposition (or occasionally in the transverse position) at 37 weeks or beyond.
When will I be offered this?
ECV is a very safe procedure with very few risks to either you or your baby.However, about 1 in 200 babies will become distressed during the procedureand an emergency caesarean section may have to be performed. Because ofthis your baby’s heart rate will be monitored before, during and after theprocedure.
There is a small risk of some of baby’s blood being transferred from theplacenta into your blood stream and if your blood group is Rhesus negative thiscould potentially cause problems in later pregnancies.
To prevent this you will be given an injection of Anti D following the procedure.This is the same as the injection you received at 30 weeks.
What are the risks to my baby?
3
(1) ‘External Cephalic Version and reducing the incidence of breechpresentation’ RCOG Green-top Guidelines Number 20A. December 2010.
The majority of women describe the procedure as no more than uncomfortable- if you are in pain the Doctor will, of course, stop the procedure.
You may be given an injection prior to the procedure which will relax yourwomb - some women say that the medication makes their heart race and theymay feel a little sick. This should pass quite quickly.
The procedure will not cause you to go into labour.
What are the risks to me?
The procedure itself will only take 5-10 minutes but we recommend that yourbaby is monitored before and after the procedure. This will take approximatelyan hour in total.
How long will it take to do?
Babies are successfully turned in about 40% of times when women are in theirfirst pregnancy and about 60% of times if it is their second or more pregnancy.
Even if the procedure is unsuccessful, 3% of babies will turn themselves into thehead first position before labour.
Will it be successful?
4
The ECV will be done on labour ward or in a scan room by a Doctor. The ECVis performed on or near labour ward to allow for the 1 in 200 babies thatbecome distressed and may need an emergency caesarean section.
Where will it be done?
If the baby is still breech when you are at your due date or when you go intolabour, you will be able to have a discussion with your Doctor whether youprefer to have a caesarean section or try to deliver the baby vaginally in thebreech position.
What if it is not successful or I ask the Doctor to stop?
Yes.
l If you have had a previous Caesarean section or major operation on youruterus.
l If your waters have broken or if the fluid surrounding the baby is reduced.
l If you have had a recent vaginal bleed or the placenta is low lying.
l If the baby is very small and the blood flow from the placenta is reduced.
l If the baby’s heart tracing is not normal.
If you think that any of these things might apply to you, please discuss thiswith your Doctor.
If you have any further questions regarding ECV please don’t hesitate to askyour Midwife or Doctor.
Are there any reasons whyI can’t have an ECV?
5
6
Notes
7
Notes
Printed on Recycled Stock by Falkirk Printworks Tel: 01324 501490 Fax: 01324 501491 e-mail: [email protected]
Re-order Ref: PIL/1147/WCCS Review Date: 2020
We are happy to consider requests for this publication in other languagesor formats such as large print. Please call 01324 590886 (24hrs), fax 01324 590867 or email [email protected]
NHS Forth ValleyAdministration Offices
Westburn Avenue, Falkirk FK1 5SUwww.nhsforthvalley.com
SMOKING IS NOT PERMITTED ON NHS FORTH VALLEY PREMISESThis includes corridors, doorways, car parks and any of our grounds. If youdo smoke on NHS premises you may be liable to prosecution and a fine.
If you can’t go let us know!Every month around 2,000 people across Forth Valley fail to turn up for hospitalappointments. This costs the NHS millions of pounds each year and increaseswaiting times. So if you are unable to attend or no longer require your hospitalappointment please let us know so we can offer it to someone else.
For all the latest health news visit www.nhsforthvalley.comfollow us on @NHSForthValleyor like us on at www.facebook.com/nhsforthvalley
