Effect of external cephalic version in late pregnancy on presentation at delivery: a randomized controlled trial
Article Abstract:
Vaginal delivery of infants in a breech presentation (feet or buttocks first) is complicated and risky and is the reason why these infants are often delivered by cesarean section (surgical delivery of the infant whereby an incision is made through the abdominal wall and the uterine muscle). Although fetal complications are reduced when infants in a breech position are delivered by cesarean section, the surgical risks to the mother can not be overlooked. One alternative, external cephalic version, is a controversial technique performed to externally turn the fetus so that the head presents first. Repeated efforts may be needed as the fetus often reverts back to the breech presentation. The effect of this procedure on fetal and maternal well being was examined in 180 women with breech presentation fetuses. Successful version was accomplished in 25 percent of all attempts in the 90 women, and repeated external cephalic version resulted in head presentation in 48 percent. Version was spontaneous in 26 percent of the non-treated control group. It was estimated that the procedure resulted in a beneficial gain of 22 percent. Repeated gentle external cephalic version lasting no longer than five minutes done between 33 and 40 weeks of pregnancy was found to reduce the number of breech presentations at birth and had no associated complications. This reduction in breech presentations will ultimately limit the need to deliver these infants by cesarean sections.
Publication Name: British Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0306-5456
Year: 1989
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Single ventricle and pulmonary hypertension: a successful pregnancy - case report
Article Abstract:
A 10-year-old girl was diagnosed with a single ventricle heart defect and high blood pressure in the lung circulation (pulmonary hypertension). Since heart surgery to repair the defect was associated with a high mortality rate, the procedure was declined by her parents. Over the years, the patient developed decreased exercise tolerance and mild cyanosis, blue skin coloring due to lack of oxygen in the blood. At 22 years of age, the woman, who was now considering pregnancy, was re-evaluated. Although it was decided that the risk of a pregnancy was too great, the patient conceived. At 12 weeks of pregnancy, atrial fibrillation, an abnormal heart rhythm originating in the atrium of her heart, developed and she was hospitalized. She began taking digoxin to control the atrial fibrillation. The remainder of the pregnancy was uneventful. At 36 weeks of pregnancy, early labor was established and a normal male infant was born. On the fifth day after delivery, the patient developed cyanosis and difficulty breathing. Excess fluid in the lungs was diagnosed and treated with the diuretic furosemide (Lasix). The patient went home two weeks later and continues to remain well. This is the only known pregnancy where the mother was able to survive pulmonary hypertension and single ventricle heart defect. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: British Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0306-5456
Year: 1989
User Contributions:
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