Schlensker K H, Enderer-Steinfort G, Bolte A
Geburtshilfe Frauenheilkd. 1978 Sep;38(9):744-53.
External cephalic version was tried in 58 from 146 cases of breech presentation after the 36th week of gestation and was successful in 55 per cent. The incidence of breech delivery was reduced from 5.3 to 4.2 per cent. With increasing weeks of gestation there was no rise in the failure rate. External version was more successful in multiparas than in primigravidas and in patients with high or low weight than in patients with normal weight and a thick muscular abdominal wall. The most frequent causes of failed versions were a thick muscular abdominal wall, extended legs and an already fixed breech in the pelvic inlet. 76 per cent of the deliveries took place within 10 days after the attempt of version. The weight of the newborns was except one over 2500 g, the average weight after successful version was 3250 g and after failed version 2930 g. Different severe fetal complications were seen after failed version but none when the attempt had been successful. On account of our own examinations and a critical analysis of the literature we came to the result that external cephalic version near to term should only be done after careful taken indication with a very precautioned technique, a thorough obstetrical examination, hospitalization and delivery shortly after.
对146例妊娠36周后臀位产妇中的58例进行了外倒转术,成功率为55%。臀位分娩率从5.3%降至4.2%。随着孕周增加,失败率并未上升。外倒转术在经产妇中比初产妇更成功,在体重高或低的患者中比体重正常且腹壁肌肉厚的患者更成功。外倒转术失败最常见的原因是腹壁肌肉厚、双腿伸直以及臀位已固定于骨盆入口。76%的分娩发生在外倒转术尝试后的10天内。除1例新生儿体重外,其余新生儿体重均超过2500g,外倒转术成功后的新生儿平均体重为3250g,失败后的平均体重为2930g。外倒转术失败后出现了不同的严重胎儿并发症,但尝试成功则未出现。基于我们自己的检查以及对文献的批判性分析,我们得出结论,接近足月时的外倒转术应仅在仔细掌握适应证、采用非常谨慎的技术、进行全面的产科检查、住院并在术后不久分娩后进行。