Placental Abruption after Bricanyl Injection Prior to External Cephalic Version: A Case Report

Background: External cephalic version (EVC) is a procedure of fetal rotation to a cephalic presentation at term and tocolysis is often used to contribute to a successful ECV. Tocolysis is contraindicated if placental abruption (PA) is suspected or diagnosed. However, in rare situations it happens, even in the absence of clinical signs. Case: A 31-year-old pregnant woman at 37 weeks’ gestation with a normal pregnancy, which was planned to ECV because of breech presentation. Few minutes after the intramuscular Bricanyl administration prior to the ECV, the patient presented vaginal bleeding and hypotension. Urgent Caesarean Section (CS) was performed and placental abruption was diagnosed. Discussion: PA is a rare diagnosis and many risk factors have been reported. This case report might present another potential risk factor associated with PA, namely tocolysis injection. Since early diagnosis of PA is lifesaving and diagnosing of PA can be difficult, this report rightly urges to share the awareness of tocolysis injection as a rare risk factor for placental abruption.