Is ECV An Appropriate Treatment For Management Of Abnormal Fetal Presentation In Pregnancy?

Posted on Thu, 1 Jun 2017

Question: I am pregnant and already have one baby with a prior c section 3 years back. I am expecting in late XXXXXXX The baby should have been head down by now but it is not. I will try some natural things but may have to do an ECV after a prior c section. Please advise what methods are there to bring the baby head down. Also what are the risks of ECV for me. Thanks.

Answered by Dr. Vjollce Mbiarra (46 minutes later)

Brief Answer:
Explanation is given below....

Detailed Answer:
Hi dear and thanks for your query to healthcare magic.

I have read your question carefully and understand your concern.

If you will do or not an ECV this vary form what your doctor will choose ,their experience and what position have your baby.
If your baby is breech presentation than ECV can be done even thought you have one previous Cesarean Section ,but if your baby is in transversal position than is not possible to do an ECV.

The main and very dangerous side effect of ECV after one previous Cesarean Section is uterine rupture.

There aren't any other natural method to bring your baby head down ,except ECV.

Hope I have been helpful and please feel free for further discussion.

Best regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Vjollce Mbiarra (2 hours later)

Thanks for your response. Is there any statistics on how often uterine rupture happens in case of prior C Section.
What are the consequences of uterine rupture.
Would you suggest ECV for my situation.

Answered by Dr. Vjollce Mbiarra (23 hours later)

Brief Answer:
I would suggest a second Cesarean Section

Detailed Answer:
Hi dear again!

Although no large studies have evaluated the safety of ECV following cesarean delivery, several smaller case series have supported its use.
The controversy over ECV after cesarean is twofold.
First, it is unknown what effect the abdominal manipulations of ECV have on a uterine scar.
Second, although the current ACOG recommendation supports vaginal birth after cesarean, a physiologic risk to uterine integrity similar to ECV, many practitioners remain uncomfortable with this practice.

In our country we don't practice ECV ,hence in my practice as an obstetrician I haven't experience .
Hence I would suggest a second Cesarean Section.

The consequences of uterine rupture is urgent Cesarean section ,because both mother and fetus are in risk .

Hence as I have mentioned above if you will do or not ECV vary from what your
doctor will choose for you and what you will decide .

Hope I have been helpful and please feel free for further discussion.

Regards

Above answer was peer-reviewed by : Dr. Prasad