Objectives To present the consequences of and risk factors for abnormal bleeding after ECV (external cephalic version). Methods We conducted a retrospective chart review at a single center in Japan. Abnormal bleeding was defined as vaginal bleeding and/or intrauterine hemorrhage. We descriptively assessed birth outcomes among women with abnormal bleeding, and investigated the risk factors using a logistic regression analysis. Results Of 477 women who received ECV, 39 (8.2%) showed abnormal bleeding, including 16 (3.4%) with intrauterine hemorrhage. Of the 16 women with intrauterine hemorrhage, 14 required emergency cesarean section; none experienced placental abruption, a low Apgar score at 5 min (<7), or low umbilical cord artery pH (<7.1). Among 23 women who had vaginal bleeding without intrauterine hemorrhage, four cases underwent emergency cesarean section and one case of vaginal delivery involved placental abruption. The risk of abnormal bleeding was higher in women with a maximum vertical pocket (MVP) of <40 mm in comparison to those with an MVP of >50 mm (adjusted odds ratio [OR]: 3.48, 95% confidence interval [CI]: 1.23–9.90), as was higher in women with unsuccessful ECV than in those with successful ECV (aOR: 4.54, 95% CI: 1.95–10.6). Conclusions A certain number of women who underwent ECV had abnormal bleeding, including vaginal bleeding and/or intrauterine hemorrhage, many of them resulted in emergency cesarean section. Although all of cases with abnormal bleeding had good birth outcomes, one case of vaginal bleeding was accompanied by placental abruption. Small amniotic fluid volume and unsuccessful ECV are risk factors for abnormal bleeding.

中文翻译：

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头颅外翻术后异常出血的危险因素及结局

目的 介绍 ECV（外部头部版本）后异常出血的后果和危险因素。方法 我们在日本的一个中心进行了回顾性图表审查。异常出血定义为阴道出血和/或子宫内出血。我们描述性地评估了异常出血女性的出生结局，并使用逻辑回归分析调查了危险因素。结果 477 例接受 ECV 的女性中，39 例（8.2%）出现异常出血，其中 16 例（3.4%）出现宫腔出血。16 名宫内出血妇女中，14 名需要紧急剖宫产；没有人经历过胎盘早剥、5 分钟时 Apgar 评分低 (<7) 或脐带动脉 pH 值低 (<7.1)。在 23 名阴道流血但无宫腔出血的女性中，4例紧急剖宫产，1例阴道分娩涉及胎盘早剥。与 MVP > 50 mm 的女性相比，最大垂直口袋 (MVP) <40 mm 的女性发生异常出血的风险更高（调整优势比 [OR]：3.48，95% 置信区间 [CI]： 1.23-9.90），ECV 失败的女性比 ECV 成功的女性更高（aOR：4.54，95% CI：1.95-10.6）。结论 一定数量的接受ECV的妇女出现异常出血，包括阴道流血和/或宫腔内出血，其中许多导致紧急剖宫产。尽管所有异常出血病例的分娩结局都很好，但有 1 例阴道出血伴有胎盘早剥。