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In this protocol, Dr. Hankins reviews the pathophysiology, diagnosis, and management of external cephalic version. Included are step-by-step guidelines for performing the procedure with illustrations of the manuevers required for successful cephalic version with 2 operators or 1.

AUTHOR: GARY D. V. HANKINS, PROFESSOR AND CHAIR, DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, AND JENNIE SEALY DISTINGUISHED PROFESSOR IN OBSTETRICS AND GYNECOLOGY, UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON

SYNOPSIS: Dr. Hankins reviews the pathophysiology, diagnosis, and management of external cephalic version. Included are step-by-step guidelines for performing the procedure with illustrations of the maneuvers required for successful cephalic version with 2 operators or 1.

As the author notes, careful assessment of fetal presentation in the third trimester is important. Otherwise, patients may be deprived of the option of external cephalic version to decrease the risk of cesarean delivery. Before the procedure, fetal well-being and the presence of any contraindications should be ascertained. Informed consent and counseling with regard to the likelihood of success of the procedure should be performed. Post-version assessment for fetal presentation on subsequent encounters is vital in these patients.

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