The procedure is undertaken by either one or two physicians and where emergency facilities to undertake instrumental delivery and caesarian section are at hand. Blood is also taken for cross-matching should a complication arise. Prior to performing<unk> , an ultrasound of the abdomen is performed to confirm the breech position and the mother's blood pressure and pulse are taken. A cardiotocography (CTG) is also performed to monitor the baby's heart. The procedure usually lasts a few minutes and is monitored intermittently with CTG. With a covering of ultrasonic gel on the abdomen to reduce friction, the physician's hands are placed on the mother's abdomen around the baby. Then, by applying firm pressure to manoeuvre the baby up and away from the pelvis and to gently turn in several steps from breech, to a sideways position, the final manipulation results in a head first presentation. The procedure is discontinued if maternal distress, repeated failure or fetal compromise on monitoring occurs.<unk>  performed before term may decrease the rate of breech presentation compared to<unk>  at term, but may increase the risk of preterm delivery. There is some evidence to support the use of tocolytic drugs in<unk> . Given by injection, tocolytics relax the uterus muscle and may improve the chance of turning the baby successfully. This is considered safe for the mother and baby, but can cause the mother to experience facial flushing and a feeling of a fast heart rate. Use of intravenous nitroglycerin has been proposed. Following the procedure, a repeat CTG is performed and a repeat ultrasound will confirm a successful turn. Should this first attempt fail, a second attempt on another day can be considered. In addition, to prevent Rh disease after the procedure, all rhesus D negative pregnant women are offered an intramuscular injection of anti-Rh antibodies (Rho(D) immune globulin).
External cephalic version
Cordotomy
Omphalotomy
Cordectomy
Vaginal delivery
Trial of labour
Lower segment Caesarean section
Infant massage