Case report
Prolapsed cord after external cephalic version in a patient with premature rupture of membranes and transverse lie

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Abstract

A 29-year-old G6 P3023 woman presented at 37 weeks’ gestation with rupture of membranes and oligohydramnios. After informed consent was obtained, a successful external cephalic version (ECV) was performed. The patient went into spontaneous labor, but about 2 h after the ECV, the umbilical cord prolapsed, necessitating cesarean section. Umbilical cord prolapse is a possible complication of ECV in patients with rupture of membranes and oligohydramnios.

Introduction

External cephalic version (ECV) is used extensively to reduce the incidences of breech presentation at delivery and cesarean section. There has been minimal experience with the use of ECV in patients with rupture of membranes [1], [2], [3]. Two previous reports have shown success in two patients with ruptured membranes and adequate amniotic fluid volume [2], [3]. This is the first report of ECV in a patient with rupture of membranes and low amniotic fluid volume.

Section snippets

Case report

A 29-year-old G6 P3023 woman presented at 37 weeks’ gestation by last menstrual period and an 18 weeks ultrasound, having ruptured the membranes on the day she was scheduled for ECV. The ECV had been arranged for a transverse lie and her medical, surgical, and family histories were unremarkable. She had had a spontaneous abortion in 1985, two uncomplicated term spontaneous vaginal deliveries in 1987 and 1992, and one spontaneous and one therapeutic abortion in 1993. Speculum examination

Comment

This is both the first reported case of ECV at term with both rupture of the membranes and a low amniotic fluid volume and the first report of complications with ECV with term rupture of membranes. There are only three previous reports on ECV in the presence of rupture of membranes. Ferguson and Dyson [1] reported unsuccessful intrapartum ECV in seven patients with rupture of membranes, and stopped performing the procedure because of it being “uniformly unsuccessful”. Drexler et al. [2]

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