Management of Breech

1) Confirm the date (if early, still can wait)
2) do US:  to type the breech & find possible causes
3) Offer pt ECV @ 37 weeks POG

1. Criteria
• No Contraindication
• EFW < 3.5 kg
• Adequate liquor
• Flexed Hd
2. Prepare for ECV
1. Consent
2. Explain: Procedure, Risk, NBM 6 HR, put IV line
3. Ix: 
• FBC, GSH, Rh Status (give anti-D to Rh-ve Mother)
• CTG: 1 HR before & after (check Fetal HR)
• US: favorable
• ECG: before & after (detect arrhythmia)
4. Cx of ECV:
• Mother: PROM, HPT, PA
• Fetus: Rh Isoimmunization, Fetal distress, Cord prolapse, Pre-Term labour 
5. Max: 3 attempt 
• 2nd attemt can give Tocolytic agent (but do ECG 1st) 
6. If Fail:
• Counsell regarding LSCS or
• Breech Vaginal delivery