External Version

Version, External 

a manual obstetrical procedure to correct breech presentation of a fetus to cephalic presentation by means of external manipulation. The use of external version has substantially reduced the number of stillbirths resulting from breech presentation. The fetus is turned 180°: the head is displaced from the fundus of the uterus toward the entrance of the pelvis minor, and the pelvic end is displaced in the opposite direction.

External version is performed in the 34th to the 36th week of pregnancy. There must be accurate diagnosis of the presentation, position, and appearance of the fetus, and the anterior abdominal wall and the uterine walls must be flexible and relaxed. External version can be performed only if fetal movement and the size of the maternal pelvis are normal. The procedure is contraindicated if the woman suffers from complications of pregnancy (hemorrhage, late toxicoses, severe general illness) or has a history of spontaneous abortion or premature delivery. It is also inadvisable in cases of hydramnios, oligohydramnios, and twin pregnancy. External version is not used when the maternal pelvis is narrow or when there are cicatricial changes of the vagina that make vaginal delivery impossible. The procedure is also avoided if hydrocephalus of the fetus is suspected. The presence of postoperative scars on the uterus, improper uterine development, and the presence of tumors on the uterus or its appendages also make external version impossible.

REFERENCE

Grishchenko, I. I., and A. E. Shuleshova. Dorodovye ispravleniia nepravil’nykh polozhenii i tasovykh predlezhanii ploda. Kiev, 1968.

A. P. KIRIUSHCHENKOV