if pt comes to OPD at 37 wks with Breech presentation and we decided for ECV. During procedure, fetal bradycardia was observed (and we suspected cord entanglement around the neck) and thus we have repositioned the baby to its original position and fetal FHS became totally normal. What should be done next?
(A) Try rotating the baby/ECV again
(B) Send the pt home & Try ECV next week
(C) Emergency LSCS
(D) Planned LSCS at 39 week
In this scenario where fetal bradycardia was observed during the attempted external cephalic version (ECV), it’s important to prioritize the safety and well-being of both the mother and the baby. Here’s the recommended course of action based on the information provided:
(C) Emergency LSCS (Lower Segment Caesarean Section)
Explanation:
- Fetal bradycardia during an ECV can indicate distress or compromised blood flow to the fetus, which is a serious concern.
- Suspecting cord entanglement around the neck further elevates the risk to the fetus.
- Repositioning the baby to its original position with a return to normal fetal heart sounds is an encouraging sign but does not eliminate the risk that was observed during the ECV.
- Emergency LSCS is the safest and most timely option to protect the well-being of the baby and prevent potential harm associated with a compromised fetal condition.
In an emergency situation like this where there are signs of fetal distress during a procedure, timely decision-making and intervention are crucial to ensure the best outcome for both the mother and the baby.