The Effect of External Cephalic Version on Fetal Circulation: A Prospective Cohort Study
External cephalic version (ECV) is a cost-effective and safe treatment option for breech presentation at term. Following ECV, fetal well-being is assessed via a non-stress test (NST). An alternative option to identify signs of fetal compromise is via the Doppler indices of the umbilical artery (UA),...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/10/2/354 |
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| author | Offra Engel Shmuel Arnon Gil Shechter Maor Hanoch Schreiber Ettie Piura Ofer Markovitch |
| author_facet | Offra Engel Shmuel Arnon Gil Shechter Maor Hanoch Schreiber Ettie Piura Ofer Markovitch |
| author_sort | Offra Engel |
| collection | DOAJ |
| description | External cephalic version (ECV) is a cost-effective and safe treatment option for breech presentation at term. Following ECV, fetal well-being is assessed via a non-stress test (NST). An alternative option to identify signs of fetal compromise is via the Doppler indices of the umbilical artery (UA), middle cerebral artery (MCA) and ductus venosus (DV). Inclusion criteria were an uncomplicated pregnancy with breech presentation at term. Doppler velocimetry of the UA, MCA and DV were performed up to 1 h before and up to 2 h after ECV. The study included 56 patients who underwent elective ECV with a success rate of 75%. After ECV, the UA S/D ratio, UA pulsatility index (PI) and UA resistance index (RI) were increased compared to before the ECV (<i>p</i> = 0.021, <i>p</i> = 0.042, and <i>p</i> = 0.022, respectively). There were no differences in the Doppler MCA and DV before or after ECV. All patients were discharged after the procedure. ECV is associated with changes in the UA Doppler indices that might reflect interference in placental perfusion. These changes are probably short-term and have no detrimental effects on the outcomes of uncomplicated pregnancies. ECV is safe; yet it is a stimulus or stress that can affect placental circulation. Therefore, careful case selection for ECV is important. |
| first_indexed | 2024-03-11T08:59:35Z |
| format | Article |
| id | doaj.art-15aa66f261f14c899d2b3297c4565012 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-11T08:59:35Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-15aa66f261f14c899d2b3297c45650122023-11-16T19:49:35ZengMDPI AGChildren2227-90672023-02-0110235410.3390/children10020354The Effect of External Cephalic Version on Fetal Circulation: A Prospective Cohort StudyOffra Engel0Shmuel Arnon1Gil Shechter Maor2Hanoch Schreiber3Ettie Piura4Ofer Markovitch5Obstetrical & Gynecological Ultrasound Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba 4428164, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, IsraelObstetrical & Gynecological Ultrasound Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba 4428164, IsraelObstetrical & Gynecological Ultrasound Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba 4428164, IsraelObstetrical & Gynecological Ultrasound Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba 4428164, IsraelObstetrical & Gynecological Ultrasound Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba 4428164, IsraelExternal cephalic version (ECV) is a cost-effective and safe treatment option for breech presentation at term. Following ECV, fetal well-being is assessed via a non-stress test (NST). An alternative option to identify signs of fetal compromise is via the Doppler indices of the umbilical artery (UA), middle cerebral artery (MCA) and ductus venosus (DV). Inclusion criteria were an uncomplicated pregnancy with breech presentation at term. Doppler velocimetry of the UA, MCA and DV were performed up to 1 h before and up to 2 h after ECV. The study included 56 patients who underwent elective ECV with a success rate of 75%. After ECV, the UA S/D ratio, UA pulsatility index (PI) and UA resistance index (RI) were increased compared to before the ECV (<i>p</i> = 0.021, <i>p</i> = 0.042, and <i>p</i> = 0.022, respectively). There were no differences in the Doppler MCA and DV before or after ECV. All patients were discharged after the procedure. ECV is associated with changes in the UA Doppler indices that might reflect interference in placental perfusion. These changes are probably short-term and have no detrimental effects on the outcomes of uncomplicated pregnancies. ECV is safe; yet it is a stimulus or stress that can affect placental circulation. Therefore, careful case selection for ECV is important.https://www.mdpi.com/2227-9067/10/2/354external cephalic versionumbilical arterydopplervelocimetryplacentafetal circulation |
| spellingShingle | Offra Engel Shmuel Arnon Gil Shechter Maor Hanoch Schreiber Ettie Piura Ofer Markovitch The Effect of External Cephalic Version on Fetal Circulation: A Prospective Cohort Study Children external cephalic version umbilical artery doppler velocimetry placenta fetal circulation |
| title | The Effect of External Cephalic Version on Fetal Circulation: A Prospective Cohort Study |
| title_full | The Effect of External Cephalic Version on Fetal Circulation: A Prospective Cohort Study |
| title_fullStr | The Effect of External Cephalic Version on Fetal Circulation: A Prospective Cohort Study |
| title_full_unstemmed | The Effect of External Cephalic Version on Fetal Circulation: A Prospective Cohort Study |
| title_short | The Effect of External Cephalic Version on Fetal Circulation: A Prospective Cohort Study |
| title_sort | effect of external cephalic version on fetal circulation a prospective cohort study |
| topic | external cephalic version umbilical artery doppler velocimetry placenta fetal circulation |
| url | https://www.mdpi.com/2227-9067/10/2/354 |
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