Fetal cephalohematoma following external cephalic version: a case report

Area of Science:

• Obstetrics
• Fetal Medicine
• Perinatal Care

Background:

• External cephalic version (ECV) is an obstetric procedure to convert breech or transverse fetal presentations to cephalic.
• ECV can increase cephalic presentations at delivery and reduce cesarean section rates for term singleton breech presentations.
• While generally safe, potential complications require careful consideration and management.

Purpose of the Study:

• To report a rare case of fetal cephalohematoma following external cephalic version.
• To contribute to the literature on potential, albeit infrequent, complications of ECV.

Main Methods:

• A 33-year-old multiparous woman with a breech presentation underwent ECV at 39 weeks and 1 day gestation.
• The procedure involved oral nifedipine for uterine relaxation and combined spinal-epidural anesthesia.
• ECV was successful after the third attempt.

Main Results:

• An ultrasound examination on the 10th postoperative day revealed a fetal cephalohematoma.
• A cesarean section was ultimately performed.
• The fetal cephalohematoma resolved gradually after birth without severe adverse effects on the newborn.

Conclusions:

• External cephalic version (ECV) is associated with few complications and can lower cesarean section rates for breech presentations.
• Strengthening perioperative management and operator skill is crucial to minimize complication risks during ECV.
• The procedure should be performed gently, avoiding unnecessary force to ensure maternal and fetal safety.