The External Cephalic Version Informed Consent is a ready-to-use healthcare & wellness template you can send for signature in minutes. It is written for 1 signer (patient) and, by default, expires 30 days after it is sent if left unsigned. It covers consent, obgyn, ecv, breech, labor delivery, maternal fetal medicine. Like every Abundera Sign template it is a convenience draft structured for ESIGN Act and UETA compliance, not a substitute for legal advice. Each signed copy is sealed with PAdES-LTA digital signatures, dual RFC 3161 timestamps, and a tamper-evident evidence package in WORM storage.
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# External Cephalic Version Informed Consent > **Important — not medical advice.** For use by a licensed provider; tailor to the patient, your protocols, and state law. **Patient Name:** ___________ **Date of Birth:** ___________ **Medical Record Number:** ___________ **Gestational Age at Procedure:** ___________ **Current Fetal Presentation:** ___________ **Ordering Provider:** ___________ **Planned Procedure Date:** ___________ --- ## 1. Procedure I, the undersigned patient, consent to external cephalic version (ECV) performed by my healthcare provider. External cephalic version is a manual procedure in which a physician applies firm, sustained pressure on the outside of the mother's abdomen to rotate the fetus from a breech or transverse position to a head-down (vertex) presentation. The goal is to allow a vaginal delivery, avoiding planned cesarean section for malpresentation. The procedure steps include: 1. Continuous electronic fetal monitoring (non-stress test) is performed before the procedure to confirm fetal wellbeing. 2. A uterine relaxant (tocolytic agent, such as terbutaline) is typically administered to relax the uterus and improve the chance of success. 3. Real-time ultrasound is used throughout to monitor fetal position, heart rate, placenta, and amniotic fluid. 4. The provider places both hands on the abdomen and gently but firmly rotates the fetus in a forward or backward roll toward vertex presentation. 5. If the fetus rotates successfully, fetal wellbeing is again confirmed by ultrasound and fetal monitoring. 6. If unsuccessful after one or two attempts, or if fetal heart rate changes occur, the procedure is stopped. 7. Rh-negative patients will receive Rh immune globulin (RhoGAM) after the procedure. ECV is typically performed at 36–38 weeks gestation in a hospital or labor and delivery setting where emergency cesarean section is immediately available. ---