A 26-year-old primigravida presents at 34 weeks of gestation with a singleton breech presentation. She wishes a vaginal delivery and asks about external cephalic version. At what gestational age should ECV be routinely offered to her?

• A Now, at 34 weeks
• B Only once labour has begun
• C After 38 completed weeks
• D After 36 completed weeks ✓

Explanation

ECV is offered from 36 weeks in nulliparous women and from 37 weeks in parous women. Performing it earlier risks spontaneous reversion to breech before labour, since there is still time for spontaneous version, whereas waiting too long reduces success rates and leaves less time to act if emergency caesarean is needed after attempted version. At 34 weeks the chance of spontaneous cephalic version is still appreciable.

Reference: RCOG Green-top Guideline No. 20a, Breech Presentation, 2017 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.