Systematic Kleihauer-Betke Test after External Cephalic Version for Breech Presentation: Is It Useful?

Area of Science:

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

Background:

• Fetomaternal hemorrhage (FMH) incidence post-external cephalic version (ECV) is not well-documented.
• Assessing the utility of routine FMH screening after ECV is crucial for clinical practice.

Purpose of the Study:

• To determine the frequency of FMH diagnosed by Kleihauer-Betke test (KBT) after ECV.
• To evaluate the clinical relevance and necessity of routine KBT screening following ECV attempts.

Main Methods:

• A prospective study of 282 women undergoing ECV for term breech presentation.
• Systematic screening for FMH using KBT after ECV attempts.
• Comparison of perinatal and neonatal outcomes between women with positive and negative KBT results.

Main Results:

• ECV success rate was 22.0%.
• FMH (positive KBT) occurred in 1.8% of women.
• No adverse fetal or neonatal outcomes were observed, irrespective of KBT result or FMH volume.

Conclusions:

• FMH after ECV is infrequent.
• Routine Kleihauer-Betke testing after attempted ECV appears to have limited clinical utility.
• Current evidence suggests no negative impact on fetal or neonatal status despite positive KBT findings.