Fetal heart rate changes following external cephalic version under tocolysis near term

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Fetal Surgery

Background:

• External cephalic version (ECV) is a procedure to non-surgically convert a fetus from a breech to a cephalic presentation.
• ECV can reduce the rate of cesarean deliveries for term breech presentations.
• Safety and fetal well-being during ECV are critical considerations.

Purpose of the Study:

• To evaluate the safety and maternal-fetal effects of external cephalic version (ECV) in near-term pregnancies.
• To assess fetal heart rate patterns during and after the ECV procedure.

Main Methods:

• Fifty-eight pregnant individuals underwent ECV near term.
• Procedures utilized tocolytic treatment and continuous fetal monitoring via cardiotocography and real-time ultrasound.
• Maternal and fetal outcomes were closely monitored.

Main Results:

• No adverse maternal or fetal effects were recorded during or after the ECV procedures.
• A transient, significant decline in fetal heart rates was observed at 10 and 30 minutes post-procedure.
• Complete recovery of fetal heart rates occurred by 1 hour, with no pathological tracings noted.

Conclusions:

• External cephalic version (ECV) with tocolytic treatment and continuous fetal monitoring is a safe procedure for near-term pregnancies.
• Temporary fetal heart rate changes following ECV are not indicative of adverse outcomes.
• ECV can be performed with a low risk of complications.