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Related Experiment Video

Updated: Feb 24, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
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Practical technique and clinical management guide for external cephalic version.

Jun Takeda1, Asako Kumagai1, Nami Tamura1

  • 1Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.

Obstetrics & Gynecology Science
|February 23, 2026
PubMed
Summary

External cephalic version (ECV) helps turn breech babies to a head-down position. This guide offers standardized techniques to improve ECV success and reduce cesarean births.

Keywords:
Breech presentationCesarean sectionExternal cephalic versionObstetric surgical procedures

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Area of Science:

  • Obstetrics and Gynecology
  • Fetal Medicine
  • Surgical Techniques

Background:

  • International guidelines recommend external cephalic version (ECV) for term breech presentations to reduce cesarean deliveries.
  • Limited standardized technical guidance and perioperative management exist for ECV.
  • ECV involves external abdominal manipulation to rotate the fetus from breech to cephalic presentation.

Purpose of the Study:

  • To provide a practical, clinically applicable guide for external cephalic version (ECV).
  • To detail preparatory measures, a step-by-step technique, and post-procedure management for ECV.
  • To support safer and more effective implementation of ECV to reduce cesarean births.

Main Methods:

  • Review of an established institutional protocol for ECV.
  • Detailed description of patient selection, informed consent, and preprocedural management (ultrasound, monitoring, ritodrine, analgesia).
  • Step-by-step explanation of the ECV technique emphasizing fetal disengagement, rotation, and engagement, with safety measures.

Main Results:

  • ECV is indicated for singleton breech pregnancies at ≥37 weeks gestation without contraindications to vaginal birth.
  • The described technique includes specific maneuvers for rotation and engagement, with ultrasound confirmation.
  • Performing ECV in an operating room with immediate cesarean access enhances safety.

Conclusions:

  • Standardized ECV guidance can improve procedural safety and effectiveness.
  • This review offers a reproducible approach to ECV, potentially reducing unnecessary cesarean births.
  • Implementation of this guide may enhance clinician confidence and patient outcomes.