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Chapter: Obstetric and Gynecological Nursing : Obstetric Operations

Obstetric Operations: Version

1. Internal Version 2. External Cephalic 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



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