External Cephalic Version

In current obstetric practice, non-vertex presentation of the fetus usually leads to cesarean delivery. Elective cesarean delivery increases the risk of neonatal respiratory complications and birth trauma compared to vaginal delivery. External cephalic version (ECV), when successful, may allow a relatively safe vertex vaginal delivery. Success rates for external cephalic version are increased using tocolytic agents and neuraxial analgesia. This chapter considers the effects of external cephalic version on the fetus, and the use of anesthesia to increase the success rate of version. We conclude that it is desirable for both mother and fetus to attempt external cephalic version.