The outcomes and risk factors of fetal bradycardia associated with external cephalic version.

Abstract

OBJECTIVE:

The objective of this study is to assess the outcomes and risk factors of fetal bradycardia after external cephalic version (ECV).

METHODS:

We performed a retrospective study of women who underwent ECV after 35 weeks of gestation in 2010-2016. We assessed the birth outcomes, including umbilical cord artery pH, according to the duration of fetal bradycardia and the risk factors for bradycardia.

RESULTS:

Among 390 cases, 189 (48.5%) cases showed fetal bradycardia during or immediately after ECV. The duration of fetal bradycardia was <1 min (n = 82, 43.4%), <5 min (n = 168, 88.9%); and <10 min (n = 186, 98.4%). All cases showed a good prognosis. Fetal bradycardia lasting >10 min occurred in three cases; emergency cesarean section was performed in each case, with delivery after 12-4 min of bradycardia. Two of three cases showed low Apgar scores at 5 min, with an umbilical cord arterial pH of <7.1. Lower maternal BMI and a prolonged ECV procedure were significantly associated with bradycardia (p for trend: .016 and .015, respectively).

CONCLUSIONS:

Fetal bradycardia lasting >10 min after ECV was a risk factor for asphyxia. Thus, delivery should be completed within 10 min after bradycardia. A low maternal BMI and a prolonged ECV procedure were risk factors for bradycardia after ECV.

• Authors: Fumio Suyama, Kohei Ogawa, Yukiko Tazaki, Terumi Miwa, Kosuke Taniguchi, Noriyuki Nakamura, Satomi Tanaka, Shinji Tanigaki, Haruhiko Sago
• Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 32 Issue 6 Pg. 922-926 (Mar 2019) ISSN: 1476-4954 [Electronic] England
• PMID: 29057691 (Publication Type: Journal Article)

Topics

• Adult
• Bradycardia (etiology)
• Breech Presentation (therapy)
• Female
• Fetal Diseases
• Gestational Age
• Heart Rate, Fetal
• Humans
• Infant, Newborn
• Outcome Assessment, Health Care
• Pregnancy
• Retrospective Studies
• Risk Factors
• Time Factors
• Version, Fetal (adverse effects)