Question

What are the complications of external cephalic version?

Hint:

ECV carries risks such as fetal bradycardia, placental abruption, and failure to turn the baby. Close monitoring and proper indications are necessary to minimize complications.

Answer 1

Step 1: Complications of External Cephalic Version (ECV).
Although external cephalic version is generally safe, it carries certain risks and potential complications. These include:
(1) Fetal Complications:
- Fetal Bradycardia: A common transient complication during the procedure, where the fetal heart rate slows down due to cord compression or uterine contractions. This usually resolves after stopping the procedure.
- Cord Prolapse: Rare, but can occur if the umbilical cord slips through the cervix after version, leading to cord compression and compromised fetal oxygenation.
- Fetal Injury: There is a small risk of placental abruption or fetal fractures due to the manipulation of the fetus during the procedure.
(2) Maternal Complications:
- Placental Abruption: ECV can cause placental separation from the uterine wall, leading to heavy bleeding and fetal distress. This is more likely if the procedure is attempted after 37 weeks or in cases of poor placental attachment.
- Preterm Labor: Although rare, ECV may trigger preterm labor or uterine rupture in certain cases.
(3) Failure of Version:
- In some cases, the version may fail, and the fetus may revert to its original position. Failure of version is more common in women with uterine abnormalities, excess amniotic fluid, or muscle tone issues.
(4) Emergency Cesarean Section:
- If the fetus is in distress or there are any other complications, an emergency cesarean section may be required after attempting ECV.