Is it necessary to perform external cephalic version for abnormal fetal position?
Nov 15, 2025
Source: Cainiu Health
Dr. Zhang Lu
Introduction
If a pregnant woman is around 36–37 weeks gestation, has no complications such as pregnancy-induced hypertension or placenta previa, and the fetus shows no issues like nuchal cord or abnormal fetal heart rate, and if the woman expresses a preference for vaginal delivery, performing external cephalic version (ECV) is advisable. Successful repositioning increases the likelihood of vaginal delivery and reduces problems associated with postoperative recovery from cesarean section, thereby better meeting the health needs of both mother and baby.
In general, external cephalic version (ECV) is recommended for breech presentation if the pregnant woman is physically suitable, the fetus shows no abnormalities, and the gestational age is appropriate; however, it is not necessary if contraindications are present. If in doubt, it is advisable to consult a healthcare provider in advance. Detailed analysis is as follows:
If the pregnant woman is around 36–37 weeks of gestation, has no complications such as pregnancy-induced hypertension or placenta previa, and the fetus shows no issues like nuchal cord or abnormal fetal heart rate, ECV is considered necessary—especially if the mother wishes to attempt vaginal delivery. A successful version increases the likelihood of vaginal birth and reduces complications associated with cesarean section, such as prolonged postoperative recovery, thereby better supporting maternal and fetal well-being.
However, ECV is unnecessary if the pregnant woman has severe pregnancy complications, if the fetus has a nuchal cord or is at risk of intrauterine distress, or if the gestational age is too advanced (beyond 38 weeks) or too early (less than 36 weeks). In these cases, the procedure carries higher risks, including placental abruption or fetal hypoxia. Cesarean delivery is safer for both mother and baby, making it unnecessary to attempt ECV.
Determination of whether to perform ECV in cases of abnormal fetal position must be made after a comprehensive evaluation by a physician and should not be decided independently. If performed, the procedure must take place in a hospital under professional monitoring, followed by close observation of fetal movements and uterine contractions to ensure the safety of both mother and baby.
