EXTERNAL CEPHALIC VERSION OBG NOTES .pptx

OBG NOTES FOR MEDICALS / NURSING INCLUDING BSC/GNM/POSTBSC

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