Abstract
BackgroundTo investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV) in breech presentation.MethodsProspective cohort study in 141 women (≥ 35 weeks gestation) with a singleton fetus in breech. Blood samples for assessing thyroid function were taken prior to ECV. Main outcome measure was the relation between maternal thyroid function and ECV outcome indicated by post ECV ultrasound.ResultsECV success rate was 77/141 (55%), 41/48 (85%) in multipara and 36/93 (39%) in primipara. Women with a failed ECV attempt had significantly higher TSH concentrations than women with a successful ECV (p < 0.001). Multiple logistic regression showed that TSH (OR: 0.52, 95% CI: 0.30-0.90), nulliparity (OR: 0.11, 95% CI: 0.03-0.36), frank breech (OR: 0.30, 95% CI: 0.10-0.93) and placenta anterior (OR: 0.31, 95% CI: 0.11-0.85) were independently related to ECV success.ConclusionsHigher TSH levels increase the risk of ECV failure.Trial registration numberClinicalTrials.gov: NCT00516555
Highlights
To investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV) in breech presentation
External cephalic version (ECV) is recommended by the American College of Obstetricians and Gynecologists (ACOG) and the Royal College of Obstetricians and Gynaecologists (RCOG) as the best method to reduce the number of breech presentations and breech deliveries at term [2,3]
Since maternal thyroid function is related to the probability of spontaneous cephalic presentation, it may be hypothesized that TSH may, affect ECV outcome [8,9]
Summary
To investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV) in breech presentation. Methods: Prospective cohort study in 141 women (≥ 35 weeks gestation) with a singleton fetus in breech. External cephalic version (ECV) is recommended by the American College of Obstetricians and Gynecologists (ACOG) and the Royal College of Obstetricians and Gynaecologists (RCOG) as the best method to reduce the number of breech presentations and breech deliveries at term [2,3]. Our research group showed that at 36 weeks gestation women with TSH levels above 2.5 mIU/l are at risk for breech presentation [8,9]. Since maternal thyroid function is related to the probability of spontaneous cephalic presentation, it may be hypothesized that TSH may, affect ECV outcome [8,9]
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