Fetomaternal macrotransfusion after external cephalic version

Background: External cephalic version is an alternative to both vaginal bre ech delivery and to caesarean section. The objective of this study was to s ummarize potential complications of external cephalic version. Which means are available for early detection and treatment of these complications? Cas e Report: A 28-year-old I/O with breech presentation was considered for ext ernal cephalic version at the 38th week of gestation. As three version atte mpts failed, the patient was discharged after normal fetal heart tone (FHT) registration and normal ultrasonographic findings on the next day. Caesare an section was planned six days later. on the day of admission, FHT registr ation revealed a decreased beat-to-beat variability and a sinusoidal baseli ne. Doppler-flow indices of the A. umbilicalis and A. cerebri media were no rmal, although middle cerebral artery peak systolic velocity was increased. Rapid caesarean sectio was performed, and an anemic baby (hemoglobin 3.4 g /dl) was born. After transfusion of 100 ml red blood cells, further develop ment of the newborn was normal. Discussion and Conclusion: Fetomaternal mac rotransfusion may be a rare complication of external cephalic version, occu rring even several days after the mechanical manipulation. FHT registration s and ultrasonographic doppler flow measurements performed periodically unt il birth are necessary to detect such complications early. The Kleihauer-Be tke test is the method of choice to diagnose fetomaternal macrotransfusion.