| Abstract [eng] |
Introduction: Fetal malpresentation and malposition account for 5 % of all births and are common indication for caesarean section. External cephalic version is an effective method to reduce the number of caesarean sections and to provide the mother with the safest way to give birth vaginally. This procedure remains controversial due to its potential complications and different techniques used. Case presentation: A 35-year-old woman was admitted for external cephalic version at 37 weeks of gestation with fetal breech presentation. The ultrasound confirmed breech presentation and revealed amniotic fluid levels within the lower normal range. An attempt was made to perform the version, however, fetal bradycardia developed, so the procedure was ended. The non-stress test recorded was reactive. After 8 days, the amniotic fluid levels increased, the external cephalic version was repeated and successful. Post-procedure ultrasound revealed fetal longitudinal position, cephalic presentation, the non-stress test was reactive. After 3 days, the patient went into spontaneous labor, presented with amniotic fluid leakage with meconium. During labor fetal bradycardia developed, thus, labor was ended by emergency caesarean section. A female newborn was born with an Apgar score of 9/10. Conclusion: The complication rate of the external cephalic version is low compared to the high success rate of the procedure. The most common complications are fetal bradycardia and maternal vaginal bleeding. Performing the procedure with an empty bladder, beta- sympathomimetic tocolysis, spinal, epidural or combined anaesthesia from the 37th week of pregnancy onwards are potentially the most important factors for the highest success rate. |
