Maternal thyroid function and the outcome of external cephalic version: a prospective cohort study

Kuppens, Simone; Kooistra, Libbe; Hasaart, T. H. M.; Donk, Riet W van der; Vader, Huib L.; Oei, Guid; Pop, Victor J M

doi:10.1186/1471-2393-11-10

Cited by 10 publications

(10 citation statements)

References 25 publications

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“…ECV performed at early gestation seems to influence the success rate indirectly through adequacy of liquor volume and nonengagement of presenting part as shown by Aisenberry et al 13 In our study, BMI was found to be one of the strongest determinants of ECV success as reported by Ben Mier et al, 11 while some authors have used ease of palpation of fetal head as an indirect assessment of BMI. 5,13 Similarly, positive association of flexed breech with success of ECV has been reported in many studies previously, 4,10,12 which is in accordance with our results.…”

Section: Discussionsupporting

confidence: 83%

“…This was similar to that reported by Hutton et al (49.1%) 9 and Kuppens et al (55%). 10 The success rate in local studies varies from 47 to 67.5% while that in international studies is quoted from 48 to 77%. 7 Our study showed that both scoring systems had significant correlation with success of ECV.…”

Section: Discussionmentioning

confidence: 99%

“…Similar association have been reported by other researchers signifying the importance of this variable. 5,7,[10][11][12] It is hypothesized that decreased tone in the uterus and abdominal wall in multiparous women allows the external version to proceed with less physical effort and less patient discomfort.…”

Section: Discussionmentioning

confidence: 99%

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GNK-PIMS Score: A Predictive Model for Success of External Cephalic Version

Tasnim¹,

Mahmud²,

Javaid³

2012

Journal of South Asian Federation of Obstetrics and Gynaecology

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Objective: To determine association of GNK-PIMS score vs Newmann Peacock score with success of external cephalic version (ECV). Materials and methods:This comparative cross-sectional analysis was carried out at MCH center Unit I, PIMS, Islamabad, from 1st January 2006 to 31st December 2009. Characteristics of 166 breech versions performed during study period were integrated into both Newmann Peacock score and GNK-PIMS score. Association of the two scoring systems with success of ECV was determined using Student t-test, correlation coefficient, Chi-square test and Cox and Snell test. The individual characteristics of two scores were also evaluated by stepwise linear regression model. Results:The success rate of ECV was 49.9%. Newman Peacock score had weaker correlation with success of ECV (r = 0.234, p = 0.001) than GNK-PIMS score (r = 0.716, p = 0.000). The success rate was 6.3% at a score of <3 and 60% at >8 with Newmann Peacock score while that with GNK-PIMS score was nil at a score of <3 and 100% at >8. All individual parameters of the GNK-PIMS score had significant association with success of ECV compared to only three variables of Newman Peacock score. Conclusion:GNK-PIMS score is stronger predictor of ECV success than Newman Peacock score. Larger randomized controlled trials should be conducted based on this scoring system.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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GNK-PIMS Score: A Predictive Model for Success of External Cephalic Version

Tasnim¹,

Mahmud²,

Javaid³

2012

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…Our meta‐analysis showed a significantly increased risk of prematurity (OR 1·3; 95% CI: 1·05–1·60) and placental abruption (OR 2·16; 95% CI: 1·15–4·06), which could be factors mediating the poor perinatal outcomes associated with subclinical hypothyroidism. Circulating TSH concentrations >95th centile at 36 weeks have also been associated with breech presentation (Table B) and a reduced external cephalic version success rate …”

Section: Subclinical Hypothyroidismmentioning

confidence: 99%

Optimal management of hypothyroidism, hypothyroxinaemia and euthyroid TPO antibody positivity preconception and in pregnancy

Chan

Boelaert

2014

Clinical Endocrinology

112

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SummaryNormal physiological changes of pregnancy warrant the need to employ gestation specific reference ranges for the interpretation of thyroid function tests. Thyroid hormones play crucial roles in foetal growth and neurodevelopment which are dependent on adequate supply of maternal thyroid hormones from early gestation onwards. The prevention of significant adverse obstetric and neurodevelopmental outcomes from hypothyroidism requires a strategy of empirical levothyroxine dose increases and predictive dose adjustments in pregnancy combined with regular thyroid function testing, starting before pregnancy and until the postpartum period. Subclinical hypothyroidism has been associated with an increased risk of pregnancy loss and neurocognitive deficits in children, especially when diagnosed before or during early pregnancy. Whilst trials of levothyroxine replacement for mild hypothyroidism in pregnancy have not indicated definite evidence of improvements in these outcomes, professional guidelines recommend treatment, especially if evidence of underlying thyroid autoimmunity is present. Studies of isolated hypothyroxinaemia in pregnancy have shown conflicting evidence with regards to adverse obstetric and neurodevelopmental outcomes and no causative relationships have been determined. Treatment of this condition in pregnancy may be considered in those with underlying thyroid autoimmunity. Whilst the evidence for a link between the presence of anti-TPO antibodies and increased risks of pregnancy loss and infertility is compelling, the results of ongoing randomized trials of levothyroxine in euthyroid women with underlying autoimmunity are currently awaited. Further studies to define the selection of women who require levothyroxine replacement and to determine the benefits of a predictive dose adjustment strategy are required.

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“…2 Furthermore, in a separate study, the same group has also shown that high serum TSH is associated with an increased risk of failure of external cephalic version (ECV) in women with breech presentation. 3 However, the association between breech presentation and maternal hypothyroidism needs replication in other populations. Therefore, we aimed to assess, in a UK population, whether there is an increased prevalence of thyroid dysfunction in women presenting with a breech position in late gestation.…”

Section: Maternal Thyroid Function In Pregnant Women With a Breech Prmentioning

confidence: 99%

Maternal thyroid function in pregnant women with a breech presentation in late gestation

Knight

Shields

Sturley

et al. 2016

Clinical Endocrinology

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Maternal thyroid function and the outcome of external cephalic version: a prospective cohort study

Cited by 10 publications

References 25 publications

GNK-PIMS Score: A Predictive Model for Success of External Cephalic Version

GNK-PIMS Score: A Predictive Model for Success of External Cephalic Version

Optimal management of hypothyroidism, hypothyroxinaemia and euthyroid TPO antibody positivity preconception and in pregnancy

Maternal thyroid function in pregnant women with a breech presentation in late gestation

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