Maternal thyroid function and the outcome of external cephalic version: a prospective cohort study

Simone M Kuppens, Libbe Kooistra, Tom H Hasaart, Riet W van der Donk, Huib L Vader, Guid S Oei, Victor J Pop, Simone M Kuppens, Libbe Kooistra, Tom H Hasaart, Riet W van der Donk, Huib L Vader, Guid S Oei, Victor J Pop

Abstract

Background: 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. 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.

Results: ECV 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.

Conclusions: Higher TSH levels increase the risk of ECV failure.

Trial registration number: ClinicalTrials.gov: NCT00516555.

Figures

Figure 1
Figure 1
Percentage of ECV success in relation to TSH quartiles (mIU/l) in 141 women with breech presentation ≥ 35 weeks gestation.

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Source: PubMed

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