Obstetrics & Gynaecology
External Cephalic Version
External Cephalic Version clinical pathway.
Source: RCOG — GTG 20a
Step 1 of ~3
info
Pre-procedure
• Consent: Risks: Placental abruption (0.5%), cord accident, fetal bradycardia, emergency CS
• Ultrasound - confirm breech, placental position, liquor volume
• CTG - reassuring trace
• Nil by mouth
• IV access
• Anti-D if Rh negative
• Placenta praevia
• Recent antepartum haemorrhage
• Major uterine anomaly
• Previous classical CS
• Multiple pregnancy (except delivery of 2nd twin)
• Fetal anomaly
• Severe IUGR
• Oligohydramnios
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Methylene Blue · Guanylate Cyclase / Nitric Oxide Pathway Inhibitor
- Sodium phenylbutyrate · Ammonia scavenger (alternative pathway)
- Marstacimab · Anti-tissue factor pathway inhibitor (TFPI) monoclonal antibody
- Glasdegib (Specialist drug) · Hedgehog pathway inhibitor
- Vismodegib (Specialist drug) · Hedgehog pathway (SMO) inhibitor
Decision support only. Always apply local guidelines and clinical judgement.