ABSTRACT
ADVANCES AND CHALLENGES IN EXTERNAL CEPHALIC VERSION FOR FETAL POSITIONING: A COMPREHENSIVE REVIEW
Matrix Science Medica (MSM)
Author: Olumuyiwa Femi Adewumi, Taiwo Temitope Adeojo, Khadijat Kuburat Babalola, Emmanuel Obem Okwari, Mukhtar Adekunle Muhibi, Tosin Paul Otepola
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
DOI: 10.26480/msm.01.2025.06.12

External cephalic version (ECV) is a critical obstetric intervention aimed at repositioning breech or transverse-presenting fetuses to a cephalic position, thereby reducing the likelihood of cesarean deliveries and associated complications. This review explores key dimensions of ECV, including ethical and psychological considerations, clinical recommendations, and future directions. Ethical concerns centre on informed consent and shared decision-making, emphasizing the importance of transparent communication and patient autonomy. The psychological impact, particularly maternal anxiety and its influence on procedural outcomes, highlights the need for empathetic patient care and psychological support. Clinical recommendations underscore the significance of evidence-based practices, including the use of ultrasound guidance, effective pain management, and careful patient selection to maximize procedural safety and success rates. A multidisciplinary approach involving obstetricians, midwives, ultrasonographers, and anesthesiologists is essential for delivering comprehensive care. Barriers to ECV, such as provider knowledge gaps, patient acceptance, and resource constraints, particularly in low-resource settings, necessitate targeted interventions to improve accessibility and uptake. Emerging trends in ECV, including technological advancements like improved imaging techniques and the exploration of non-invasive alternatives, show promise for enhancing procedural efficacy and patient acceptance. However, gaps in research remain, particularly concerning the long-term psychological outcomes of ECV and the role of cultural factors in shaping patient attitudes. Addressing disparities in access to ECV through mobile health units, community-based training, and innovative solutions is critical for ensuring equitable care. ECV is a valuable procedure with the potential to improve maternal and fetal outcomes, but it requires a patient-centred, multidisciplinary approach. Future research and innovation should focus on addressing barriers, leveraging technology, and promoting equitable access. By advancing clinical practice and integrating ethical and psychological considerations, ECV can continue to evolve as a safe, effective, and widely accessible intervention for managing malpresentation.