COMPUTERIZED ANALYSIS OF FETAL HEART-RATE CHANGES AFTER ANTEPARTUM EXTERNAL CEPHALIC VERSION

OBJECTIVE: To assess the fetal heart rate (FHR) changes following exte rnal cephalic version using a computerized FHR monitor. STUDY DESIGN: We performed 116 external cephalic versions on 106 pregnant women at 3 6-40 weeks' gestation. Tocolysis (magnesium sulfate) was given to 39 p atients (34%). Computerized FHR monitoring was performed for 20-30 min utes before and for 20-30 mintrtes after the procedure. In addition, w e analyzed the results of the FHR tracing obtained during the first 10 minutes following the procedure. RESULTS: External cephalic version w as successful in 40% of the patients. In the group of patients who zoe re not treated with magnesium sulfate, FHR variation and the number of accelerations per 10 minutes were significantly reduced during the fi rst 10 mintrtes following the procedure as compared with those factors on the FHR tracings obtained before or 20-30 mintrtes following the p rocedure (P <.05). In the group of patients patients who zoere treated with magnesium sulfate, FHR variation and the number of accelerations per 10 minutes were significantly reduced before and 10 minutes after the procedure as compared with FHR tracings obtained 20-30 minutes fo llowing the procedure (P <.05). In both groups the basal FHR teas sign ificantly lower during the first 20-30 mintrtes following the procedur e TP <.05). FHR decelerations were observed following the procedure in only two patients. None of the 106 fetuses had a low Apgar score or w ere admitted to the neonatal intensive care unit. CONCLUSION: External cephalic version appears to be safe for the mother and fetus, althoug h transient FHR changes may occur following the procedure.