WOMEN AND NEWBORN HEALTH SERVICE

King Edward Memorial Hospital

CLINICAL GUIDELINES
SECTION B: OBSTETRICS AND MIDWIFERY CARE

2 COMPLICATIONS OF PREGNANCY
2.10 ABNORMALITIES OF LIE / PRESENTATION
Date Issued: August 1993
Date Revised: April 2012
Review Date: April 2015
Authorised by: OGCCU
Review Team: OGCCU

2.10.1 Breech presentation

Section B
Clinical Guidelines
King Edward Memorial Hospital
Perth Western Australia

2.10.1 BREECH PRESENTATION

BACKGROUND INFORMATION
Breech presentation occurs in 3% to 4% of pregnancies at term. The randomised multicentre Term
Breech Trial (TBT) showed that a planned elective caesarean section (ELUSCS) reduces the risk for
adverse perinatal outcomes or serious maternal morbidity when compared to a planned vaginal
2
breech birth in the short term. Long term follow-up at 2 years has not found neonatal neurological
outcomes or maternal outcomes differing between women who had a ELUSCS compared to vaginal
4 6
breech birth.
A large study conducted in the Netherlands following the TBT study found that the
rapid increase in caesarean section rates resulted in substantial improvements in perinatal outcomes
leading to halving of perinatal mortality rates, and ever greater reductions in the incidence of perinatal
3, 7, 8
birth trauma.
However, the view remains that if the application of strict criteria before and during
labour is met, planned vaginal delivery of a singleton breech at term is a reasonable management
1, 9
option.
External cephalic version (ECV) from 36 weeks has been shown to decrease the incidence of breech
3, 11
presentation at term and consequently reduce the ELUSCS rates.
It is seen as a safe procedure
provided it is performed in a setting where caesarean section can be performed if necessary. A metaanalysis looking at risk for performing an ECV indicates that fetal death risk is 1 per 5000 procedures;
12
risk for serious complications was 6.1%, and risk for requiring caesarean was 0.35%.
However, a
large cohort study found that performing an ECV may carry a higher risk for caesarean section of
13
0.5%.
A recent large multi-centre randomised study found that ECV initiated at 34-35 weeks gestation
compared with 37 weeks or more increases the probability of cephalic presentation at birth, however it
14
does not reduce rate of caesarean sections, and it may increase the risk rate for preterm birth.
KEY POINTS
1.
2.
3.
4.

5.

6.

DPMS
Ref: 5179

ELUSCS for a singleton breech at term has been shown to reduce perinatal or neonatal
2, 3
mortality rates and serious neonatal morbidity rate in the first 6 weeks of life.
Long-term follow-up at 2 years showed neurological infant outcomes do not differ by planned
3, 4
mode of delivery even in the presence of serious short term neonatal morbidity.
ELUSCS is not associated with substantially better or worst outcomes for women 2 years after
6
birth when compared to planned vaginal singleton breech birth at term.
All women with a singleton breech presentation with no contra-indications to the procedure
should be offered an ECV. Success rates for ECV are approximately 40% in nulliparous
1
women and 60% in multiparae women.
A woman attending a low-risk midwifery antenatal clinic, and who is found to have a breech
presentation at 35-36 weeks gestation shall be referred for obstetric medical review prior to 37
weeks gestation.
Careful case selection and labour management in a modern obstetrical setting may achieve a
3
level of safety similar to ELUSCS. Planned vaginal singleton breech birth is an option for
women who have no maternal or fetal contra-indications to this mode of delivery.

All guidelines should be read in conjunction with the Disclaimer at the beginning of this manual

Page 1 of 4

7.

The mode of birth for pre-term breech presentation is made based according to individual
clinical situations, and the decision is made after discussion with the team Consultant and the
woman.

ANTENATAL MANAGEMENT
Breech presentation may require different options for management:

ECV

Elective caesarean section

Planned breech vaginal birth

Undiagnosed antenatal breech presentation presenting in labour

Refer women with a breech presentation between 35-36 weeks gestation for medical obstetric
review as near as possible to 36 weeks gestation.

If there are no contra-indications the woman should be offered an ECV between 36-37 weeks
gestation. An ECV at 34-36 may be performed with Consultant approval. The woman should
be advised of the risk for preterm birth associated with performing ECV at this gestation.

Prior to booking an ECV explanation about the procedure shall be given including risks, sideeffects, and outcomes.

Ultrasound examination should be performed to assess presentation (type of breech, exclude

hyperflexion of the head), placental location, amniotic fluid volume and to exclude any fetal
and uterine anomalies.

The procedure is performed in the Maternal Fetal Assessment Unit (MFAU).

Depending on the maternal decision regarding mode of delivery obtain written consent:
ELUSCS on the MR295 Generic consent form
ECV on the MR295.75 Consent form for external cephalic version

See Clinical Guidelines, Section B 2.10.2 External Cephalic Version for detailed information
about the procedure and contraindications.

EXTERNAL CEPHALIC VERSION

ECV for uncomplicated term breech presentation should be offered to nulliparous women from 36
weeks gestation, and for multiparous women from 37 weeks gestation if there are no contraindications to the procedure.
See:
Clinical Guidelines, Section B 2.10.2 External cephalic version

Clinical Guidelines, Section B 2.10.2.1 Maternal Fetal Assessment Unit Quick Reference
Guide External Cephalic Version.

ELECTIVE CAESAREAN SECTION

ELUSCS should be booked for women who elect this mode of birth.
UNDIAGNOSED BREECH PRESENTING IN LABOUR
The decision regarding mode of delivery will depend on gestation, stage of labour or imminent birth,
and parental wishes after consultation with the obstetric team. Following counselling and ensuring the
criteria are met for a safe vaginal breech birth, a woman may be choose this option of birth.
DIAGNOSED BREECH BOOKED FOR E.L.U.S.C.S PRESENTING IN LABOUR
The management plan may be adjusted depending on the gestation, clinical situation and consultation
with the woman and her obstetric team. Proceed to ELUSCS if breech presentation is verified, and
the woman confirms her request for this mode of delivery.

Date Issued: June 2002

Date Revised: April 2012
Review Date: April 2015
Written by:/Authorised by: OGCCU
Review Team: OGCCU
DPMS Ref: 5179

2.10.1 Breech presentation

Section B
Clinical Guidelines
King Edward Memorial Hospital
Perth Western Australia

All guidelines should be read in conjunction with the Disclaimer at the beginning of this manual

Page 2 of 4

CRITERIA RECOMMENDED FOR A PLANNED VAGINAL BREECH TERM BIRTH

The woman has completed a consent form after counselling regarding risks and
outcomes of a breech birth compare to an ELUSCS.

Availability of an experienced obstetrician/doctor trained in breech delivery.

The woman should have a clinically adequate pelvis.

Exclusion of a growth restricted fetus

Exclusion of a footling or kneeling breech . The breech should be in the frank or

complete breech position.

The fetus has a flexed head

Estimated fetal weight is between 2500g and 3800g

Immediate theatre facilities should be available for caesarean section if required.

No previous caesarean section.

No fetal anomaly incompatible with vaginal birth

Absence of fetal or maternal compromise

Continuous fetal heart rate monitoring during labour.

1, 3

1, 3

or macrosomia

3-6

1
1, 10

Note: for criteria and management of a vaginal breech birth see Clinical Guideline,
Section B 2.10.3 Breech Labour and Birth Management

Pre-term Breech Vaginal Birth

The mode of birth is decided by the woman and the Obstetric team following discussion based on
1
individual circumstances.
REFERENCES
1.
2.
3.
4.

5.

6.

7.
8.

9.

Royal College of obstetricians and Gynaecologists. The management of breech presentation. RCOG
Green-top Guideline No 20b. 2006.
Hannah ME, Hannah WJ, Hewson SA, et al. Planned caesarean section versus planned vaginal birth for
breech presentation at term: a randomised multicentre trial. The Lancet. 2000;356:1375-83.
Society of Obstetricians and Gynaecologist of Canada. Vaginal Delivery of Breech Presentation. Journal
of Obstetric Gynaecology of Canada. 2009(June):557-66.
Whyte H, Hannah ME, Saigal S, et al. Outcomes of children at 2 years after planned cesarean birth
versus planned vaginal birth for breech presentation at term: the International Randomised Term Breech
Trial. American Journal of Obstetrics and Gynecology. 2004;191:864-71.
Goffinet F, Carayol M, Foidart J-M, et al. Is planned vaginal delivery for breech presentation at term still
an option? Results of an observational prospective survey in France and Belgium. American Journal of
Obstetrics and Gynecology. 2006;194:1002-11.
Hannah ME, Whyte H, Hannah W. Maternal outcomes at 2 years after planned cesarean section versus
planned vaginal birth for breech presentation at term: The International Randomized Term Breech Trial.
American Journal of Obstetrics and Gynecology. 2004;191:917-27.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Planned breech
deliveries at erm. RANZCOG College statement C-Obs 11. 2007.
Rietberg CC, Elferink-Stinkens PM, Visser GHA. The effect of the Term Breech Trial on medical
intervention behaviour and neonatal outcome in the netherlands: an analysisi of 35,453 term breech
infants. BJOG: an International Journal of Obstetrics and Gynaecology. 2005;112:205-9.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Management of
term breech presentation. College Statement C-Obs 11. 2009.

Date Issued: June 2002

Date Revised: April 2012
Review Date: April 2015
Written by:/Authorised by: OGCCU
Review Team: OGCCU
DPMS Ref: 5179

2.10.1 Breech presentation

Section B
Clinical Guidelines
King Edward Memorial Hospital
Perth Western Australia

All guidelines should be read in conjunction with the Disclaimer at the beginning of this manual

Page 3 of 4

10.

Taillefer C, Dube J. Single Breech at Term: Two Continents, Two Approaches. JOGC.
2010(March):238-43.

11.

Hofmeyr GJ, Kulier R. External cephalic version for breech presentation at term. The Cochrane
Database of Systematic reviews. 2011(1).
Grootscholten K, Kok M, Oei G, et al. External Cephalic Version-Related Risks A Meta-analysis.
Obstetrics & Gynecology. 2008;112(5):1143-51.
Collins S, Ellaway P, Harrington D, et al. The complications of external cephalic version: results from 805
consecutive attempts. BJOG: an International Journal of Obstetrics and Gynaecology.
2007;114:636-38.
Hutton EK, Hannah ME, Ross SJ. The Early External Cephalic Version (ECV) 2 Trial: an international
multicentre randomised controlled trial of timing of ECV for breech pregnancies. BJOG: an International
Journal of Obstetrics and Gynaecology. 2011;118:564-77.

12.
13.

14.

Date Issued: June 2002

Date Revised: April 2012
Review Date: April 2015
Written by:/Authorised by: OGCCU
Review Team: OGCCU
DPMS Ref: 5179

2.10.1 Breech presentation

Section B
Clinical Guidelines
King Edward Memorial Hospital
Perth Western Australia

All guidelines should be read in conjunction with the Disclaimer at the beginning of this manual

Page 4 of 4

2.10 Kelainan pada LIE / PRESENTASI

Tanggal Dikeluarkan: Agustus 1993 2.10.1 Sungsang presentasi
Tanggal Revisi: April 2012 Bagian B
Ulasan Tanggal: April 2015 Pedoman Klinis
Disahkan oleh: OGCCU Raja Edward Memorial Hospital
Ulasan Tim: OGCCU Perth Australia Barat
2.10.1 breech
INFORMASI LATAR BELAKANG
Breech terjadi pada 3% sampai 4% dari kehamilan aterm. The acak
multisenter Term Sungsang Trial (TBT) menunjukkan bahwa operasi caesar
elektif direncanakan (ELUSCS) mengurangi risiko untuk hasil perinatal yang
merugikan atau morbiditas maternal yang serius bila dibandingkan dengan
kelahiran sungsang vagina yang direncanakan dalam term.2 pendek jangka
panjang tindak lanjut di 2 tahun belum menemukan hasil neurologis
neonatal atau hasil maternal berbeda antara wanita yang memiliki ELUSCS
dibandingkan dengan vagina sungsang birth.4 6 sebuah penelitian besar
yang dilakukan di Belanda setelah studi TBT menemukan bahwa
peningkatan pesat dalam tingkat operasi caesar menghasilkan perbaikan
substansial dalam hasil perinatal menyebabkan mengurangi separuh angka
kematian perinatal, dan pengurangan semakin besar dalam kejadian
trauma.3 perinatal kelahiran, 7, 8 Namun, pandangan tetap bahwa jika
penerapan kriteria yang ketat sebelum dan selama persalinan terpenuhi,
direncanakan persalinan pervaginam dari sungsang tunggal di jangka
adalah option.1 manajemen yang wajar, 9
Versi cephalic eksternal (ECV) dari 36 minggu telah terbukti menurunkan
kejadian presentasi bokong pada jangka dan akibatnya mengurangi rates.3
ELUSCS, 11 Hal ini terlihat sebagai prosedur yang aman asalkan dilakukan
dalam pengaturan di mana operasi caesar dapat dilakukan jika diperlukan.
Sebuah analisis meta melihat risiko untuk melakukan suatu ECV
menunjukkan bahwa risiko kematian janin adalah 1 per 5000 prosedur;
risiko komplikasi serius adalah 6,1%, dan risiko yang membutuhkan operasi
caesar adalah 0,35% 0,12 Namun, sebuah studi kohort besar menemukan
bahwa melakukan sebuah ECV dapat membawa risiko lebih tinggi untuk
operasi caesar dari
0,5% .13
Sebuah multi-pusat besar baru-baru acak studi menemukan bahwa ECV
dimulai pada 34-35 minggu kehamilan dibandingkan dengan 37 minggu
atau lebih meningkatkan kemungkinan presentasi kepala saat lahir, namun
tidak mengurangi tingkat operasi caesar, dan dapat meningkatkan tingkat
risiko untuk prematur birth.14
KUNCI
Date Issued: June 2002
Date Revised: April 2012
Review Date: April 2015
Written by:/Authorised by: OGCCU
Review Team: OGCCU
DPMS Ref: 5179

2.10.1 Breech presentation

Section B
Clinical Guidelines
King Edward Memorial Hospital
Perth Western Australia

All guidelines should be read in conjunction with the Disclaimer at the beginning of this manual

Page 5 of 4

1. ELUSCS untuk sungsang tunggal di jangka telah terbukti mengurangi

angka kematian perinatal atau neonatal dan angka kesakitan neonatal
serius dalam 6 minggu pertama dari life.2, 3
2. jangka panjang tindak lanjut pada 2 tahun menunjukkan hasil bayi
neurologis tidak berbeda dengan modus yang direncanakan pengiriman
bahkan di hadapan jangka pendek morbidity.3 neonatal serius, 4
3. ELUSCS tidak terkait dengan jauh lebih baik atau hasil terburuk bagi
perempuan 2 tahun setelah kelahiran bila dibandingkan dengan kelahiran
sungsang direncanakan vagina tunggal di term.6
4. Semua wanita dengan presentasi sungsang tunggal tanpa kontraindikasi prosedur harus ditawarkan ECV. Tingkat keberhasilan untuk ECV
sekitar 40% pada wanita nulipara dan 60% di multiparae perempuan.1
5. Seorang wanita yang menghadiri klinik kebidanan antenatal berisiko
rendah, dan yang ditemukan memiliki presentasi sungsang di 35-36
minggu kehamilan harus dirujuk untuk kebidanan tinjauan medis sebelum
37 minggu kehamilan.
6. seleksi kasus yang cermat dan manajemen tenaga kerja dalam
pengaturan kandungan yang modern dapat mencapai tingkat keamanan
yang serupa dengan ELUSCS.3 Rencana kelahiran sungsang tunggal vagina
merupakan pilihan bagi wanita yang tidak memiliki kontra-indikasi ibu atau
janin ke mode ini pengiriman.

DPMS Ref: 5179

Semua pedoman harus dibaca bersama dengan disclaimer pada awal this
Page petunjuk 1 dari 4
7. Modus lahir untuk presentasi sungsang prematur yang dibuat
berdasarkan sesuai dengan situasi klinis individu, dan keputusan dibuat
setelah diskusi dengan Konsultan tim dan wanita.
MANAJEMEN ANTENATAL
Breech mungkin memerlukan pilihan yang berbeda untuk manajemen:
ECV
operasi caesar elektif
Rencana sungsang kelahiran vagina
terdiagnosis presentasi sungsang antenatal menyajikan tenaga kerja
Rujuk wanita dengan presentasi sungsang antara 35-36 minggu
kehamilan untuk ditinjau kebidanan kesehatan sedekat mungkin untuk 36
minggu kehamilan.
Jika tidak ada kontra-indikasi wanita harus ditawarkan ECV antara 36-37
minggu kehamilan. Sebuah ECV di 34-36 dapat dilakukan dengan
persetujuan Konsultan. Wanita itu harus diberitahu tentang risiko kelahiran
prematur terkait dengan melakukan ECV pada usia kehamilan ini.
Sebelum pemesanan penjelasan ECV tentang prosedur akan diberikan
termasuk risiko, efek samping, dan hasil.
Date Issued: June 2002
Date Revised: April 2012
Review Date: April 2015
Written by:/Authorised by: OGCCU
Review Team: OGCCU
DPMS Ref: 5179

2.10.1 Breech presentation

Section B
Clinical Guidelines
King Edward Memorial Hospital
Perth Western Australia

All guidelines should be read in conjunction with the Disclaimer at the beginning of this manual

Page 6 of 4

 Pemeriksaan USG harus dilakukan untuk menilai presentasi (jenis

sungsang, termasuk hiperfleksi kepala), lokasi plasenta, volume cairan
amnion dan untuk mengecualikan setiap anomali janin dan rahim.
Prosedur ini dilakukan di Unit Maternal Fetal Assessment (MFAU).
Tergantung pada keputusan ibu mengenai cara persalinan memperoleh
persetujuan tertulis:
ELUSCS pada formulir persetujuan Generik yang MR295 '"
ECV pada 'bentuk Persetujuan untuk versi sefalik eksternal yang
MR295.75
Lihat Pedoman Klinis, Bagian B 2.10.2 Eksternal Cephalic Version untuk
informasi rinci tentang prosedur dan kontraindikasi.
Cephalic EKSTERNAL VERSION
ECV untuk tidak rumit jangka sungsang harus ditawarkan kepada wanita
nulipara dari 36 minggu kehamilan, dan untuk wanita multipara dari 37
minggu kehamilan jika tidak ada indikasi kontrasepsi prosedur.
Lihat:
Pedoman Klinis, Bagian B 2.10.2 versi cephalic Eksternal
Pedoman Klinis, Bagian B 2.10.2.1 Unit Penilaian Fetal Maternal Referensi Cepat
Panduan Eksternal Cephalic Version.
PILIHAN operasi caesar
ELUSCS harus dipesan untuk wanita yang memilih mode ini lahir.
Menyajikan sungsang terdiagnosis DI TENAGA KERJA
Keputusan mengenai cara persalinan akan tergantung pada usia
kehamilan, tahap persalinan atau kelahiran dekat, dan keinginan orang tua
setelah berkonsultasi dengan tim kebidanan. Setelah konseling dan
memastikan kriteria terpenuhi untuk kelahiran sungsang vagina yang
aman, seorang wanita mungkin memilih opsi ini lahir.
DIDIAGNOSIS sungsang MEMESAN UNTUK ELUSCS Menyajikan DI TENAGA
KERJA
Rencana pengelolaan dapat disesuaikan tergantung pada kehamilan,
situasi klinis dan konsultasi dengan wanita dan tim obstetri nya. Lanjutkan
ke ELUSCS jika posisi sungsang diverifikasi, dan
wanita menegaskan permintaannya untuk mode ini pengiriman.

KRITERIA YANG DISARANKAN UNTUK KELAHIRAN JANGKA RENCANA VAGINA

Sungsang

Wanita itu telah menyelesaikan formulir persetujuan setelah konseling

mengenai risiko dan hasil dari kelahiran sungsang dibandingkan dengan
sebuah ELUSCS.
Ketersediaan berpengalaman dokter kandungan / dokter terlatih dalam
sungsang delivery.1
June 2002
2.10.1 Breech presentation

Date Issued:
Date Revised: April 2012
Review Date: April 2015
Written by:/Authorised by: OGCCU
Review Team: OGCCU
DPMS Ref: 5179

Section B
Clinical Guidelines
King Edward Memorial Hospital
Perth Western Australia

All guidelines should be read in conjunction with the Disclaimer at the beginning of this manual

Page 7 of 4

 Wanita itu harus memiliki pelvis.1 klinis yang memadai, 3

Pengecualian pertumbuhan dibatasi fetus1, 3 atau macrosomia3-6
Pengecualian dari breech1 goblok atau berlutut. Sungsang harus dalam
posisi sungsang jujur atau lengkap.
Janin memiliki head1 tertekuk
Perkiraan berat janin antara 2500g dan 3800g1, 10
fasilitas teater segera harus tersedia untuk operasi caesar jika
diperlukan.
Tidak ada operasi caesar sebelumnya.
Tidak ada anomali janin tidak sesuai dengan birth3 vagina
Tidak adanya kompromi janin atau ibu
pemantauan denyut jantung janin terus-menerus selama labour.1
Catatan: kriteria dan pengelolaan kelahiran sungsang vagina melihat
Pedoman Klinis, Bagian B 2.10.3 Sungsang - Buruh dan Manajemen Lahir

Sungsang jangka Pra - Lahir vagina

Modus kelahiran ditentukan oleh wanita dan Kebidanan tim pembahasan
berikut berdasarkan circumstances.1 individu
REFERENSI
1. Royal College of dokter kandungan dan Gynaecologists. Manajemen
presentasi bokong. RCOG Hijau-top Pedoman Tidak ada 20b. 2006.
2. Hannah ME, Hannah WJ, Hewson SA, et al. Direncanakan operasi caesar
dibandingkan persalinan vagina direncanakan untuk posisi sungsang di
jangka: uji coba multisenter acak. The Lancet. 2000; 356: 1375-1383.
3. Masyarakat of Obstetricians dan ginekolog dari Kanada. Pengiriman
vagina Sungsang Presentasi. Journal of Obstetri Ginekologi Kanada. 2009
(Juni): 557-66.
4. Whyte H, Hannah ME, Saigal S, et al. Hasil dari anak-anak pada 2 tahun
setelah direncanakan kelahiran sesar dibandingkan direncanakan kelahiran
normal untuk posisi sungsang di jangka: Internasional Acak Term Sungsang
Trial. American Journal of Obstetri dan Ginekologi. 2004; 191: 864-71.
5. Goffinet F, Carayol M, Foidart J-M, et al. Direncanakan persalinan
pervaginam untuk posisi sungsang di jangka masih menjadi pilihan? Hasil
survei calon pengamatan di Perancis dan Belgia. American Journal of
Obstetri dan Ginekologi. 2006; 194: 1002-1011.
6. Hannah ME, Whyte H, Hannah W. Ibu hasil-hasil pada 2 tahun setelah
direncanakan operasi caesar dibandingkan persalinan vagina direncanakan
untuk posisi sungsang di jangka: The International Acak Term Sungsang
Trial. American Journal of Obstetri dan Ginekologi. 2004; 191: 917-27.
7. Royal Australian dan New Zealand College of Obstetricians dan
Gynaecologists. Pengiriman sungsang direncanakan pada erm. RANZCOG
Perguruan Pernyataan C-Obs 11. 2007.
8. Rietberg CC, Elferink-Stinkens PM, Visser GHA. Pengaruh Jangka
Sungsang Percobaan pada perilaku intervensi medis dan hasil neonatal di
belanda: sebuah analisis balik bayi sungsang 35.453 istilah. BJOG: an
International Journal of Obstetri dan Ginekologi. 2005; 112: 205-9.
9. Royal Australian dan New Zealand College of Obstetricians dan

Date Issued: June 2002

Date Revised: April 2012
Review Date: April 2015
Written by:/Authorised by: OGCCU
Review Team: OGCCU
DPMS Ref: 5179

2.10.1 Breech presentation

Section B
Clinical Guidelines
King Edward Memorial Hospital
Perth Western Australia

All guidelines should be read in conjunction with the Disclaimer at the beginning of this manual

Page 8 of 4

Gynaecologists. Pengelolaan sungsang jangka presentasi. Pernyataan

perguruan C-Obs 11. 2009.
10. Taillefer C, Dube J. Tunggal Sungsang di Term: Dua Benua, Dua
Pendekatan. JOGC.
2010 (Maret): 238-43.
11. Hofmeyr GJ, Kulier R. Eksternal versi cephalic untuk presentasi
sungsang di jangka panjang. The Cochrane
Database tinjauan sistematis. 2011 (1).
12. Grootscholten K, Kok M, Oei G, et al. Risiko eksternal Cephalic VersionTerkait A Meta-analisis.
Obstetrics & Gynecology. 2008; 112 (5): 1143-1151.
13. Collins S, Ellaway P, Harrington D, et al. Komplikasi versi cephalic
eksternal: Hasil dari 805 kali berturut-turut. BJOG: an International Journal
of Obstetri dan Ginekologi.
2007; 114: 636-38.
14. Hutton EK, Hannah ME, Ross SJ. Awal Eksternal Cephalic Version (ECV)
2 Trial: sebuah multisenter internasional acak percobaan terkontrol waktu
ECV untuk kehamilan sungsang. BJOG: an International Journal of Obstetri
dan Ginekologi. 2011; 118: 564-77.

Date Issued: June 2002

Date Revised: April 2012
Review Date: April 2015
Written by:/Authorised by: OGCCU
Review Team: OGCCU
DPMS Ref: 5179

2.10.1 Breech presentation

Section B
Clinical Guidelines
King Edward Memorial Hospital
Perth Western Australia

All guidelines should be read in conjunction with the Disclaimer at the beginning of this manual

Page 9 of 4