What is a version in pregnancy?

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An external cephalic version is a procedure used to help turn a baby in the womb before delivery. During the procedure, your healthcare provider places their hands on the outside of your belly and attempts to manually turn the baby. This procedure may be recommended if your baby is in a breech position.

What does breech extraction mean?

A breech extraction refers to the procedure in which the infant’s feet are grasped by the operator and the fetus is extracted from the uterine cavity through the vagina. It is performed for the delivery of the second twin in a vertex/nonvertex presentation.

How do you perform breech extraction?

Apply gentle, continuous, downward traction on the leg to deliver the anterior hip, the foetal back anteriorly. Once the anterior hip has been delivered, pull gradually upward to deliver the posterior hip. Once the pelvis is out, with thumbs on the loins, take hold of the hips and pelvis with the other fingers.

What is internal podalic version mean?

Internal podalic version comprises a series of manoeuvres performed prior to breech extraction to deliver a fetus with a persistent transverse or oblique lie in the second stage of labour.

How often are versions successful?

External cephalic version is a procedure that externally rotates the fetus from a breech presentation to a vertex presentation. External version has made a resurgence in the past 15 years because of a strong safety record and a success rate of about 65 percent.

Can you do a version on a footling breech?

Material and methods: External cephalic version was attempted in thirteen patients in labor with footling breech presentation with the breech out of the pelvis. Results: The procedure was successful in twelve of the thirteen patients. Ten of them delivered vaginally. There were no maternal or neonatal complications.

What is internal version?

Obstetrics A transvaginal procedure that converts a difficult fetal presentation to a vaginally deliverable situation by hand-rotating the fetus in utero.

How do you deliver a breech baby after C-section?

To deliver the fetus, the operator grasps the fetal buttocks, hooking his/her index finger on the fetal bilateral groins, and pulls the fetal body gently, similar to the usual breech extraction maneuver. The femoral region must never be pulled with a finger over it.

What is the difference between external cephalic version and internal podalic version?

It is changing the transverse lie to a longitudinal one or replacement the presenting pole by the other. If the aim is to make the head the presenting part it is called cephalic version and if the breech will be the presenting part it is podalic version.

How is internal podalic version done?

During internal version the accoucheur completes a series of manoeuvres with one hand inside the uterus, usually with the aim of bringing one or both feet through a fully dilated cervix, hence the term internal podalic version.

How painful is an external cephalic version?

There will be mild to moderate pain while doing an external cephalic version (ECV). Throughout the procedure, the doctor will keep asking you whether you can bear the pain. However, if the pain becomes excruciating, the doctor will right away stop ECV.

What is a breech extraction?

What are the steps involved in breech delivery?

Following the delivery of the first twin, the following steps are used for the breech delivery of the second twin: With ultrasound assess (a) the heart rate and (b) the presentation of the second twin Place a hand in vagina and grasp the feet as in Fig 12.1 (it is important to differentiate between hands and feet) Fig. 12.1.

What is the procedure for the extraction of the second twin?

Breech extraction of the second twin, in particular when the condition of the foetus requires rapid extraction (foetal distress); may be preceded by internal version for transverse foetal lie. This technique requires experience in obstetrical manoeuvres. If possible, it should be performed in a CEmONC facility.

Can breech delivery of the second twin be delayed?

The delivery of the second twin should not be delayed because the cervix may “clamp down” around the presenting part. If the fetal heart tracing is nonreassuring and an expedited delivery is needed, proceed with the breech extraction immediately.