Objective: To reinforce the risk of feto-maternal haemorrhage associated with external cephalic version for breech presentation. Method: A single case report with a literature review. Results: Our case report was associated with the largest feto-maternal haemorrhage following external cephalic version reported so far. The perinatal outcome in this case was favourable despite a significant amount of fetal haemorrhage. The literature review did include cases with unfavourable outcomes. No reliable method of monitoring fetuses with feto-maternal haemorrhage has been reported, although middle cerebral artery Doppler studies appear to show promise. Conclusion: External cephalic version is useful in the management of breech presentations at term, but it is not without risks and clinicians need to be aware of this.

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