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Massive feto-maternal transfusion during external cephalic version, with fatal outcome
Archiv Fur Gynakologie
|October 15, 1976
Summary
External cephalic version (ECV) in a primipara with breech presentation led to a massive feto-maternal hemorrhage and fetal demise. This case highlights potential risks associated with ECV, especially with anterior placenta.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Perinatology
Background:
- External cephalic version (ECV) is a procedure to externally manipulate a fetus from a breech to a cephalic presentation before labor.
- While generally considered safe, ECV carries potential risks, including feto-maternal hemorrhage.
- Anterior placenta location may influence ECV success and complication rates.
Observation:
- A primipara with a breech presentation underwent ECV 9 days before her estimated due date.
- The procedure was performed under tocolysis to relax the uterus.
- The placenta was noted to be on the anterior uterine wall.
Findings:
- During the ECV procedure, a massive feto-maternal transfusion occurred.
- Despite the intervention, the fetus ultimately died following the massive transfusion.
Implications:
- This case underscores the critical risk of feto-maternal hemorrhage during ECV, particularly in cases with an anterior placenta.
- Careful patient selection and counseling regarding potential complications are essential for ECV procedures.
- Further research may be warranted to elucidate risk factors and optimize ECV safety protocols.