Sunoo Christian S, Bhattacharyya Eesha R
Department of Obstetrics and Gynecology, Kaiser Permanente Medical Group, Honolulu, HI, USA.
Hawaii Med J. 2003 Dec;62(12):277, 293.
Breech presentation occurs in approximately 4% of term pregnancies. Recently the American College of Obstetrics and Gynecology has suggested that cesarean section is the safest option if the fetus remains in breech position. As an alternative to cesarean section, external cephalic version has been used prior to labor and even recently in the patient with rupture of membranes not in labor. We present two cases found at our institution from 1990 through 2001, who at term presented in early labor with spontaneous rupture of membranes and underwent successful external cephalic version.
Two women presented to labor and delivery with spontaneous rupture of membranes and were found to be in early labor with cervical dilatation. Both underwent successful external cephalic version. As labor progressed, each ultimately underwent cesarean section to accomplish delivery. One patient underwent cesarean section for failure to progress and the other for severe variable decelerations associated with an umbilical cord prolapse.
External cephalic version is possible in the term pregnancy with ruptured membranes and in early labor, but the patient remains susceptible to complications of version and labor.
臀位在足月妊娠中发生率约为4%。最近，美国妇产科医师学会建议，如果胎儿仍为臀位，剖宫产是最安全的选择。作为剖宫产的替代方法，在临产前甚至最近在未临产胎膜破裂的患者中也采用了外倒转术。我们报告了1990年至2001年在我们机构发现的两例病例，她们足月时在产程早期出现胎膜自发破裂，并成功接受了外倒转术。
两名女性因胎膜自发破裂就诊于分娩室，发现处于产程早期且宫颈扩张。两人均成功接受了外倒转术。随着产程进展，两人最终均接受剖宫产以完成分娩。一名患者因产程无进展而接受剖宫产，另一名因与脐带脱垂相关的严重变异减速而接受剖宫产。
足月妊娠胎膜破裂且处于产程早期时外倒转术是可行的，但患者仍易发生倒转术和产程的并发症。
