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External Cephalic Version (ECV) and Reducing the Incidence of Breech Presentation (Green-top Guideline No. 20a)

Published: 01/12/2006

Update November 2014: This guideline is currently being revised, with publication anticipated late 2016. The version available on the website and app will remain valid until replaced.

This is the first edition of this guideline. 

External cephalic version (ECV) is the manipulation of the fetus, through the maternal abdomen, to a cephalic presentation. The rationale behind ECV is to reduce the incidence of breech presentation at term and therefore the associated risks, particularly of avoidable caesarean section. This guideline summarises the evidence regarding the routine use of ECV for breech presentation.

The evidence concerning mode and technique of delivery of the persistent breech presentation is summarised in Green-top Guideline No. 20b, The Management of Breech Presentation.