Anesthetic Management for External Cephalic Version

Abstract

Approximately 3% to 4% of term fetuses are in breech presentation, and this is a common indication for cesarean delivery. Twenty percent of elective cesarean sections are due to breech position. External cephalic version (ECV) is an obstetric maneuver that applies external pressure to the fetal posture through the maternal abdomen, to convert a breech presentation to a vertex presentation. Since the risk of adverse events after an ECV is small, the possibility of ECV should be offered in all pregnancies with breech presentation, provided that there is no contraindication. A standardized protocol, an experienced gynecologist and adequate analgesia can facilitate the maneuver and improve the success rate, turning the ECV into a maneuver with an excellent safety profile which is an interesting option to avoid a cesarean section.

Keywords: Analgesia, Anesthesia, Breech Presentation, Breech Delivey, Cesarean Section, External Cephalic Version, Epidural Anesthesia, Inhalational Anesthesia, Intravenous Anesthesia, Neuraxial Anesthesia, Remifentanyl, Spinal Anesthesia, Tocolytics.