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Fetomaternal bleeding during attempts at external version

P Gjøde, T B Rasmussen, J Jørgensen

    British Journal of Obstetrics and Gynaecology
    |July 1, 1980
    PubMed
    Summary
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    Fetomaternal bleeds can occur during external cephalic version for breech presentation. Rhesus negative pregnant women should receive anti-D immunoglobulin prophylaxis before this procedure to prevent complications.

    Area of Science:

    • Obstetrics and Gynecology
    • Maternal-Fetal Medicine
    • Immunology

    Background:

    • External cephalic version (ECV) is a procedure to turn a fetus from breech presentation to cephalic.
    • Fetomaternal hemorrhage (FMH) is a potential risk during obstetric interventions.
    • RhD incompatibility can lead to hemolytic disease of the fetus and newborn.

    Purpose of the Study:

    • To investigate the incidence and volume of fetomaternal bleeds during the initial ECV attempt.
    • To assess the need for anti-D immunoglobulin prophylaxis in RhD-negative women undergoing ECV.

    Main Methods:

    • Prospective study involving 50 pregnant women undergoing their first ECV attempt for breech presentation.
    • Detection and quantification of fetomaternal bleeds using a validated method (e.g., Kleihauer-Betke test or flow cytometry).

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    Main Results:

    • Fetomaternal bleeds were detected in 14 out of 50 women (28%).
    • The volume of detected bleeds ranged from 0.1 to 1.5 ml.
    • This indicates a significant risk of FMH during ECV.

    Conclusions:

    • External cephalic version carries a risk of fetomaternal hemorrhage.
    • RhD-negative women undergoing ECV should be administered anti-D immunoglobulin prior to the procedure.
    • Prophylactic anti-D administration is crucial to prevent RhD alloimmunization.