The outcomes and risk factors of fetal bradycardia associated with external cephalic version

Suyama, Fumio; Ogawa, Kohei; Tazaki, Yukiko; Miwa, Terumi; Taniguchi, Kosuke; Nakamura, Noriyuki; Tanaka, Satomi; Tanigaki, Shinji; Sago, Haruhiko

doi:10.1080/14767058.2017.1395846

Cited by 9 publications

(11 citation statements)

References 10 publications

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“…• Severe preeclampsia or eclampsia: Fetuses of women with this condition commonly develop heart rate deceleration after ECV. A previous study reported that nearly 50% of the fetuses evaluated in that study showed abnormal heart rate tracings during or immediately after the procedure [22], which suggests that although transient, ECV is a stressful event for the fetus [15].…”

Section: Contraindications To External Cephalic Versionmentioning

confidence: 99%

“…• Transient abnormal cardiotocography patterns: With an incidence rate of 5.7–9.6%, a transient abnormal cardiotocography pattern is the most commonly reported complication of ECV [43]. Temporary baseline bradycardia is relatively common (9–9.6%) [4445]; however, a report from Japan has described an exceptionally high incidence of fetal bradycardia during or immediately after ECV (48.5%, 189 of 390 cases) that lasted for <1 minute in 43.3%, <5 minutes in 88.9%, and <10 minutes in 98.4% of cases [22]. Bradycardia lasting >10 minutes occurred in 3 of 390 cases (0.7%), and low Apgar scores at 5 minutes, with an umbilical cord arterial pH <7.1 were observed in 2 of these cases [22].…”

Section: Complicationsmentioning

confidence: 99%

“…• Emergency cesarean section: The risk of emergency cesarean deliveries during and after ECV reportedly ranges between 0.2% and 0.7% [1522434449], with the most common indication being an abnormal fetal heart rate pattern detected on EFM.…”

Section: Complicationsmentioning

confidence: 99%

“…If the fetal heart rate does not recover within 5 minutes, an emergency cesarean section is performed. Delivery should be completed within 10 minutes after the onset of bradycardia [22].…”

Section: Procedures Of External Cephalic Versionmentioning

confidence: 99%

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Reviving external cephalic version: a review of its efficacy, safety, and technical aspects

Kim

2019

Obstet Gynecol Sci

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Currently, the rate of cesarean sections being performed in Korea is approximately 40%, with Korea ranking 4th among the Organization for Economic Co-operation and Development countries with respect to cesarean deliveries. Breech presentation at term is an important indication for cesarean section among other factors, including medicolegal concerns and pregnancies in women of advanced maternal age. Term breech presentation is associated with a higher fetal mortality rate than that associated with a cephalic presentation. Therefore, in Korea, most of these women deliver by cesarean section to avoid the complications of vaginal breech delivery. However, cesarean section is itself associated with considerable obstetric morbidity and sometimes, mortality. External cephalic version (ECV) is a useful method to reduce the cesarean section rate in women with breech presentation and therefore to reduce the incidence of breech presentation at delivery. Studies have shown that routine use of ECV reduces the cesarean section rate by approximately two-thirds in term pregnancies with breech presentation. ECV is accepted as a safe, efficacious, and cost-effective method and is recommended by both the American College of Obstetricians and Gynecologists and the Royal College of Obstetricians and Gynecologists in all pregnancies with term breech presentation, if not contraindicated. In Korea, although most clinicians are aware of the option of ECV, their relative lack of experience in performing the procedure and fear of complications render them hesitant to perform ECV. This review is aimed at guiding obstetricians by describing the efficacy, safety concerns, and technical aspects of this procedure.

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Section: Contraindications To External Cephalic Versionmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

“…If the fetal heart rate does not recover within 5 minutes, an emergency cesarean section is performed. Delivery should be completed within 10 minutes after the onset of bradycardia [22].…”

Section: Procedures Of External Cephalic Versionmentioning

confidence: 99%

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Reviving external cephalic version: a review of its efficacy, safety, and technical aspects

Kim

2019

Obstet Gynecol Sci

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“…The rate of both maternal and perinatal complications is very low. Mild complications (transient alterations of the fetal heart rate, mild antepartum hemorrhage, premature rupture of membranes) occur in less than 5% of cases, and the most severe complications (placental abruption, emergency CS due to fetal distress) occur in less than 1% 10–13 . Most authors have even found no differences in terms of perinatal morbimortality between patients with breech presentation at term who undergo ECV and those who do not 14 …”

Section: Introductionmentioning

confidence: 99%

Prediction model of success for external cephalic version. Complications and perinatal outcomes after a successful version

López-Pérez

Lorente-Fernández

Velasco-Martínez

et al. 2020

J of Obstet and Gynaecol

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Aim: External cephalic version (ECV) is an effective and safe technique for avoiding breech presentation at birth. However, it continues rejected by many women. The aim of this study is to develop a predictive model of success of external cephalic version, determine the safety of the technique and perinatal outcomes after successful version. Methods: Data from 317 versions performed over a 6-year period were collected. Different clinical and ultrasound variables, complications, vaginal delivery after successful version and perinatal outcomes were analyzed. Results: The overall success rate was 72% (229 of 317 versions). The variables most related to success were parity, placental location, amniotic fluid volume, fetal sex, fetal head palpation and descent of the presenting part. A model for calculating the probability of success was developed in which to input parity, placentation and amniotic fluid data. The model correctly classified 98.8% of successful technique and 74% of all women. Complications were very few and mostly mild. Of women who had success, 77% (163 of 212) had a vaginal birth. No differences between neonatal outcomes were found. Conclusion: External cephalic version is a successful, safe technique with a high rate of subsequent vaginal delivery. A success prediction model based on some very easily obtained variables can personalize the probability of success.

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Sextuple loops of nuchal cord in breech presentation

Hinkson

Pahlitzsch

Henrich

2019

Ultrasound in Obstet & Gyne

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The outcomes and risk factors of fetal bradycardia associated with external cephalic version

Abstract: Fetal bradycardia lasting >10 min after ECV was a risk factor for asphyxia. Thus, delivery should be completed within 10 min after bradycardia. A low maternal BMI and a prolonged ECV procedure were risk factors for bradycardia after ECV.

Cited by 9 publications

References 10 publications

Reviving external cephalic version: a review of its efficacy, safety, and technical aspects

Reviving external cephalic version: a review of its efficacy, safety, and technical aspects

Prediction model of success for external cephalic version. Complications and perinatal outcomes after a successful version

Sextuple loops of nuchal cord in breech presentation

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