Podalic version is indicated for which scenario?

Podalic version is a procedure used in obstetrics to manipulate the fetus into a more favorable position for delivery, particularly when the fetus is not in the head-down position (cephalic presentation). The technique is particularly applied to the delivery of the second twin during a twin pregnancy.

In the case of twin pregnancies, the first twin typically presents head first; however, if the second twin is in a non-cephalic presentation, podalic version can be performed to facilitate a safer delivery. This is crucial because delivering the second twin by turning it to its breech presentation and then allowing it to be delivered vaginally can decrease the risk of complications such as entanglement in the umbilical cord or fetal distress.

In contrast, delivering the first twin in a non-cephalic presentation may involve different interventions (such as external cephalic version or cesarean section), making the focus on the second twin significant when discussing podalic version. This is why the indication for podalic version specifically pertains to the delivery of the second twin that is not in a cephalic presentation.