External Cephalic Version Contraindications Explained

External Cephalic Version (ECV) is a procedure used to turn a baby from a breech position to a head-down (cephalic) position before labor begins. However, certain conditions make this procedure unsafe or inadvisable. These are known as contraindications.

Identifying Contraindications for ECV

We need to identify which of the listed conditions are contraindications for performing an ECV on a breech presentation:

• 1. Antepartum haemorrhage (APH): Any unexplained vaginal bleeding in late pregnancy is a significant concern and generally prevents ECV due to potential risks to mother and baby. Thus, APH is a contraindication.
• 2. Multiple pregnancy: Carrying more than one baby increases the risks associated with ECV, such as placental issues or cord entanglement. It is often considered a contraindication, especially in certain scenarios.
• 3. Reactive Non Stress Test (NST): A reactive NST indicates the baby is well and receiving adequate oxygen. This is a sign of fetal well-being and is *not* a contraindication; good fetal status is usually required for ECV.
• 4. Severe oligohydramnios: A severe lack of amniotic fluid (oligohydramnios) can make ECV difficult to perform and increases the risk of complications like cord compression. Therefore, severe oligohydramnios is a contraindication.

Conclusion on Contraindications

Based on the analysis, the contraindications to external cephalic version listed are:

• Antepartum haemorrhage (1)
• Multiple pregnancy (2)
• Severe oligohydramnios (4)

A reactive NST (3) is not a contraindication.

Therefore, the correct combination is 1, 2, and 4.