What is the proper documentation procedure for an External Cephalic Version (ECV) procedure?

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From the Research

To document an External Cephalic Version (ECV) procedure, begin by recording the patient's informed consent after discussing risks, benefits, and alternatives, as supported by the most recent study 1 which compared the efficacy of atosiban versus ritodrine as tocolytics in external cephalic version.

Pre-Procedure Documentation

Document pre-procedure assessments including:

  • Gestational age
  • Fetal position confirmed by ultrasound
  • Fetal heart rate monitoring
  • Maternal vital signs Note any tocolytic medications administered (such as terbutaline 0.25mg subcutaneously or nifedipine 10mg orally) to relax the uterus, as studied in 2 and 3.

Procedure Details

Detail the procedure itself by describing:

  • The direction of manipulation (forward or backward somersault)
  • Duration of attempts
  • Number of attempts (typically limited to 2-3)
  • The healthcare providers present

Post-Procedure Documentation

Document post-procedure information including:

  • Final fetal position
  • Post-procedure ultrasound findings
  • Fetal heart rate patterns
  • Any complications
  • The patient's condition Include follow-up plans and instructions given to the patient about monitoring fetal movement and signs of labor or complications, as emphasized in 4 and 5.

Importance of Documentation

Thorough documentation is essential for continuity of care and medicolegal purposes, as it provides a clear record of the clinical decision-making process and the patient's response to the intervention, highlighting the need for accurate and detailed documentation as seen in the studies 2, 3, 1, 4, 5.

References

Research

Atosiban versus ritodrine as tocolytics in external cephalic version.

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2022

Research

Employing nifedipine as a tocolytic agent prior to external cephalic version.

Acta obstetricia et gynecologica Scandinavica, 2008

Research

Nifedipine versus ritodrine during external cephalic version procedure: a case control study.

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2021

Research

Effectiveness of nifedipine tocolysis to facilitate external cephalic version: a systematic review.

BJOG : an international journal of obstetrics and gynaecology, 2011

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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