Devendra K
Division of Fetal-Maternal Medicine, Department of Obstetrics and Gynaecology, Singapore General Hospital, Outram Road, Singapore 169608.
Med J Malaysia. 2002 Dec;57(4):454-9.
The aim of this study was to assess the efficacy and safety of external cephalic version (ECV) when its use was introduced in the routine management of breech presentation and transverse lie after 36 weeks by obstetricians with limited prior experience with the procedure. The influence of various factors on the outcome of ECV was also studied.
Retrospective study of 44 consecutive cases of ECV which were analysed with respect to outcome, parity, type of breech, placental site and birth weight.
ECV was successful in 45% of women, 80% of women with successful ECV delivered vaginally while 10% underwent spontaneous reversion to a non-cephalic presentation. In contrast, only 15% of women with failed ECV delivered vaginally. Parity, type of breech presentation and placental location did not significantly affect the outcome of ECV although there was a trend towards better success rate of ECV with multiparity, flexed breech presentation, transverse lie and posteriorly-located placentae. The mean birth weight of fetuses of women with successful ECV was significantly heavier than those of women who failed ECV (p < 0.001). No significant fetal or maternal morbidity occurred as a result of ECV in this study.
ECV is a safe and effective procedure that is useful in the management of breech presentation and transverse lie near term. The lack of prior experience with the procedure does not appear to influence the success rate or morbidity.
本研究的目的是评估在孕周36周后，由经验有限的产科医生将外倒转术（ECV）引入臀位和横位的常规管理时的有效性和安全性。还研究了各种因素对ECV结果的影响。
对44例连续的ECV病例进行回顾性研究，分析其结果、产次、臀位类型、胎盘位置和出生体重。
45%的女性ECV成功，ECV成功的女性中有80%经阴道分娩，10%自行恢复为非头位。相比之下，ECV失败的女性中只有15%经阴道分娩。产次、臀位类型和胎盘位置对ECV的结果没有显著影响，尽管经产妇、屈曲型臀位、横位和胎盘后置的ECV成功率有升高趋势。ECV成功的女性所生胎儿的平均出生体重显著高于ECV失败的女性（p < 0.001）。本研究中，ECV未导致显著的胎儿或母体并发症。
ECV是一种安全有效的方法，对足月臀位和横位的管理有用。缺乏该手术的既往经验似乎不会影响成功率或并发症发生率。
