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Related Concept Videos

Fetal Circulation01:14

Fetal Circulation

Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...

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Related Experiment Video

Updated: Jul 4, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
08:49

External Cephalic Version: Is it an Effective and Safe Procedure?

Published on: June 6, 2020

Fetomaternal hemorrhage during external cephalic version.

Marc Boucher1, Gerald P Marquette, Jocelyne Varin

  • 1Department of Obstetrics and Gynecology, Faculté de Médecine, Université de Montréal, Centre Hospitalier Universitaire, Sainte-Justine, Montréal, QC, Canada. boucherhsj@aol.com

Obstetrics and Gynecology
|July 2, 2008
PubMed
Summary

Fetomaternal hemorrhage is rare during external cephalic version (ECV), occurring in 2.4% of cases. Significant hemorrhage (>30 mL) is less than 0.1%, suggesting routine Kleihauer-Betke testing may be unnecessary.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Perinatal Research

Background:

  • External cephalic version (ECV) is used to convert breech presentations to cephalic.
  • Fetomaternal hemorrhage (FMH) is a potential complication of ECV.
  • Identifying risk factors for FMH is crucial for patient safety.

Purpose of the Study:

  • To determine the incidence and volume of FMH during ECV for term breech singleton fetuses.
  • To identify potential risk factors associated with FMH during ECV.

Main Methods:

  • Prospective observational study of 1,311 ECV trials (1987-2001).
  • Kleihauer-Betke (KB) test performed before and after ECV to detect fetal erythrocytes.
  • FMH frequency and volume calculated; risk factors analyzed using chi-squared and Mann-Whitney U tests.

Main Results:

  • A positive KB test post-ECV occurred in 2.4% of women with a negative pre-ECV test.
  • FMH >1 mL was observed in 0.8%, and FMH >30 mL in 0.08% of cases.
  • Parity, gestational age, BMI, attempts, placental location, and amniotic fluid index did not influence FMH risk.

Conclusions:

  • Detectable FMH during ECV occurs in 2.4% of cases, with significant hemorrhage (>30 mL) in <0.1%.
  • Routine KB testing after uneventful ECV is likely unwarranted.
  • Rh-negative women may not require additional Rh immune globulin beyond standard doses.