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Cephalic version refers to a procedure done to a pregnant woman in order to turn a fetus from a breech presentation to a cephalic presentation. A cephalic presentation is when the fetus is facing head down, and is considered to be the normal positioning for birth. Breech presentation means that the fetus is approaching the birth canal feet or buttocks first. Because there can be many complications during vaginal breech deliveries, most breech babies are delivered by cesarean section. Cephalic version may be performed during pregnancy in an attempt to turn the baby in order to reduce the risk of complications or need for surgery.
There are two types of cephalic version: internal and external. Because the internal type can be hazardous for the fetus, the doctor may instead recommend a cesarean section. The internal procedure, however, may still be used in an emergency. During this process, the doctor inserts his or her hand into the uterus, through the cervix, in order to directly turn the fetus.
External cephalic version is much more commonly performed than the internal method. This procedure is usually not attempted until after about 36 weeks of gestation, because many fetuses will turn from breech to cephalic presentation independently as pregnancy progresses. If the baby is still in breech presentation this late in pregnancy, it will most likely not turn by itself, and the doctor may suggest this intervention.
Before performing the procedure, the doctor will usually conduct an ultrasound to confirm that the fetus is still in breech presentation. The doctor may also perform a non-stress test before and after the cephalic version to check on the welfare of the fetus. In some cases, the mother may receive medication to relax her uterus, or anesthesia to reduce discomfort. The doctor then presses on the outside of the mother’s abdomen, using his or her hands to manually turn the fetus into the head-down position.
External cephalic version is typically done as an outpatient procedure, with some risks. There is a slight chance of premature labor, or rupture of membranes. If the fetus shows signs of distress during the procedure, and this does not improve after the procedure is stopped, a cesarean section may have to be performed. There is also the chance that after a successful cephalic version, the fetus may return to breech presentation.
On the whole, studies indicate that external cephalic version is a safe procedure when performed by trained professionals. For expectant mothers whose fetuses are in the breech presentation, a successful procedure may help reduce complications during birth. Additionally, for those women who would like to give birth vaginally, the procedure may help them avoid having a cesarean section.