External cephalic version contraindication?

External cephalic version contraindication?

• A. Placenta previa
• B. Fetus in cephalic presentation
• C. Normal amniotic fluid index
• D. Singleton pregnancy

Answer: (A)

External cephalic version is done to turn a breech fetus to head-down so vaginal delivery is more likely. Placenta previa is an absolute contraindication because the placenta lies over or near the cervix; manipulating the uterus could cause heavy bleeding and harm the fetus if the placenta were disrupted or detached. If the fetus is already cephalic, there’s no need for turning it, so that presentation isn’t a contraindication. A normal amniotic fluid index means there’s adequate fluid for safe manipulation, so it does not prevent ECV. A singleton pregnancy is compatible with the procedure, whereas multiple gestations introduce other complexities and risks. Thus, placenta previa explains why ECV should be withheld.

External cephalic version is done to turn a breech fetus to head-down so vaginal delivery is more likely. Placenta previa is an absolute contraindication because the placenta lies over or near the cervix; manipulating the uterus could cause heavy bleeding and harm the fetus if the placenta were disrupted or detached. If the fetus is already cephalic, there’s no need for turning it, so that presentation isn’t a contraindication. A normal amniotic fluid index means there’s adequate fluid for safe manipulation, so it does not prevent ECV. A singleton pregnancy is compatible with the procedure, whereas multiple gestations introduce other complexities and risks. Thus, placenta previa explains why ECV should be withheld.