Obstetric Operations: Version

 Version 

Version is the manipulation of the fetus to obtain a more favorable presentation of the baby. E.g. From breech to vertex

 

Type of Version

 

External version - Used to change the presentation in to cephalic.

Internal version - Used to make the presentation in to breech and extract the baby.

 

1. Internal Version

 

 

It is the direct manipulation of the fetus inside the uterus. It is usually done to convert the malpresentation of second twin. Internal version poses significant risk to the fetus and is now done only in extreme emergencies, such as profound fetal distress with a prolapsed cored or the need for the immediate delivery of a second twin when there is not enough time for caesarian delivery.

 

In this procedure the physician reaches up into the uterine cavity grapes feet of the fetus and draws them through the cervix and delivers the fetus as in breech presentation. Thisprocedure is extremely rare in contemporary obstetric practice.

 

2. External Cephalic Version

 

External version is turning the fetus from a breech to a cephalic presentation after 34 weeks & before 37 weeks of gestation.

 

Danger of External Version

 

i.                     Separation of placenta

 

ii.                     Rupture of membrane

 

iii.                     One set of premature labor

 

iv.                     Knotting of the umbilical cord

 

v.                     Rupture of uterus 

 

Contra indications for external versions

 

i.                     Ante partum hemorrhage

 

ii.                     Rh negetive mother

 

iii.                     Previous caesarian section

 

iv.                     Hydrocephalus

 

v.                     Hypertension or pre-eclamsia

 

vi.                     Premature labor

 

vii.                     Multiple pregnancy