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Risk factors and outcomes of abnormal bleeding after external cephalic version

  • Hitoshi Matsui , Kohei Ogawa EMAIL logo , Aikou Okamoto and Haruhiko Sago
Published/Copyright: March 18, 2021
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 49 Issue 6

Abstract

Objectives

To present the consequences of and risk factors for abnormal bleeding after ECV (external cephalic version).

Methods

We conducted a retrospective chart review at a single center in Japan. Abnormal bleeding was defined as vaginal bleeding and/or intrauterine hemorrhage. We descriptively assessed birth outcomes among women with abnormal bleeding, and investigated the risk factors using a logistic regression analysis.

Results

Of 477 women who received ECV, 39 (8.2%) showed abnormal bleeding, including 16 (3.4%) with intrauterine hemorrhage. Of the 16 women with intrauterine hemorrhage, 14 required emergency cesarean section; none experienced placental abruption, a low Apgar score at 5 min (<7), or low umbilical cord artery pH (<7.1). Among 23 women who had vaginal bleeding without intrauterine hemorrhage, four cases underwent emergency cesarean section and one case of vaginal delivery involved placental abruption. The risk of abnormal bleeding was higher in women with a maximum vertical pocket (MVP) of <40 mm in comparison to those with an MVP of >50 mm (adjusted odds ratio [OR]: 3.48, 95% confidence interval [CI]: 1.23–9.90), as was higher in women with unsuccessful ECV than in those with successful ECV (aOR: 4.54, 95% CI: 1.95–10.6).

Conclusions

A certain number of women who underwent ECV had abnormal bleeding, including vaginal bleeding and/or intrauterine hemorrhage, many of them resulted in emergency cesarean section. Although all of cases with abnormal bleeding had good birth outcomes, one case of vaginal bleeding was accompanied by placental abruption. Small amniotic fluid volume and unsuccessful ECV are risk factors for abnormal bleeding.

Keywords: cesarean section; external cephalic version; intrauterine hemorrhage; placental abruption; vaginal bleeding
Corresponding author: Kohei Ogawa, MD, PhD, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan, Phone: +81 3 3416 0181, Fax: +81 3 3416 2222, E-mail:

Acknowledgments

The authors are deeply grateful to all of the participants in the present study and to the hospital staff for their cooperation. We would also like to thank the following members of an ECV team: Terumi Miwa, Yukiko Tazaki, and Fumio Suyama. The authors would also like to thank Mr. Brian Quinn, for proofreading and editing this manuscript.

  1. Research funding: None declared.

  2. Author contributions: HM and KO initiated the concept, designed the study, and collected the data, and KO analyzed the data. HM wrote the initial manuscript. AO and HS gave critical comments on the study design and interpretation and revised the draft.

  3. Competing interests: All the authors have no conflicts of interest to disclose.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the Institutional Review Board of the NCCHD on Nov. 15, 2018 (No 1990).

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Received: 2020-09-24
Accepted: 2021-03-01
Published Online: 2021-03-18
Published in Print: 2021-07-27

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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  3. Editorial
  4. COVID-19 in pregnancy: where are we now?
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  15. Covid-19 and pregnancy: the experience of a tertiary maternity hospital
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  21. Letter to the Editor
  22. COVID-19 vaccine: the gender disparity
  23. Regular Papers
  24. Original Articles – Obstetrics
  25. Mode of delivery of women with Swyer syndrome in a German case series
  26. Risk factors and outcomes of abnormal bleeding after external cephalic version
  27. Causal analysis of fetal death in high-risk pregnancies
  28. Original Article – Neonates
  29. Prediction of encephalopathy in perinatal asphyxia score: reaching the unreached
  30. Short Communication
  31. Deoxyribonuclease activity negative correlates with extracellular DNA in uncomplicated singleton pregnancies in the third trimester
  32. Online Only: Congress Abstracts
  33. World Congress of Perinatal Medicine
https://doi.org/10.1515/jpm-2020-0453
Keywords for this article
cesarean section; external cephalic version; intrauterine hemorrhage; placental abruption; vaginal bleeding

Articles in the same Issue

  1. Frontmatter
  2. Special Section: Coronavirus Disease 2019 (COVID-19) in Obstetrics
  3. Editorial
  4. COVID-19 in pregnancy: where are we now?
  5. Review
  6. Newborns at risk of Covid-19 ― lessons from the last year
  7. Opinion Paper
  8. Ethical challenges in management of critically ill pregnant patients with coronavirus disease 2019 (COVID-19)
  9. Corner of Academy
  10. Antenatal depression and anxiety during the COVID-19 pandemic: a cross-sectional study in pregnant women from routine health care contact in Greece
  11. Original Articles – Obstetrics
  12. Pregnant women’s psychological state and influence factors: anxiety, and depression during COVID-19 outbreak
  13. Anxiety and depression during pregnancy in the era of COVID-19
  14. COVID-19 vaccine hesitancy in perinatal women: a cross sectional survey
  15. Covid-19 and pregnancy: the experience of a tertiary maternity hospital
  16. Infant outcomes and maternal COVID-19 status at delivery
  17. Assessment of fetal Doppler parameters in pregnant women with COVID-19 infection: a prospective case-control study
  18. SARS-CoV-2 in pregnancy and possible transfer of immunity: assessment of peripartal maternal and neonatal antibody levels and a longitudinal follow-up
  19. Peripartal anti-SARS-CoV-2-IgA/IgG in asymptomatic pregnant women during regional SARS-CoV-2-outbreak
  20. SARS-CoV-2 in asymptomatic pregnant women in South Brazil: RT-PCR and serological detection
  21. Letter to the Editor
  22. COVID-19 vaccine: the gender disparity
  23. Regular Papers
  24. Original Articles – Obstetrics
  25. Mode of delivery of women with Swyer syndrome in a German case series
  26. Risk factors and outcomes of abnormal bleeding after external cephalic version
  27. Causal analysis of fetal death in high-risk pregnancies
  28. Original Article – Neonates
  29. Prediction of encephalopathy in perinatal asphyxia score: reaching the unreached
  30. Short Communication
  31. Deoxyribonuclease activity negative correlates with extracellular DNA in uncomplicated singleton pregnancies in the third trimester
  32. Online Only: Congress Abstracts
  33. World Congress of Perinatal Medicine
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