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


BACKGROUND
ClinicalTrials.gov: NCT00516555.
Department of Primary Care, University of Tilburg, Tilburg, the Netherlands. s.m.i.kuppens@uvt.nl
Simone M
SM
Kuppens
Libbe
L
Kooistra
Tom H
TH
Hasaart
Riet W
RW
van der Donk
Huib L
HL
Vader
Guid S
GS
Oei
Victor J
VJ
Pop
D000328:Adult; D001946:Breech Presentation / Q000628:therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011247:Pregnancy / Q000502:physiology*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013961:Thyroid Gland / Q000502:physiology*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal; D014710:Version, Fetal; D055815:Young Adult
D013972:Thyrotropin; D013974:Thyroxine
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