Shaffer Brian L, Cheng Yvonne W, Vargas Juan E, Laros Russell K, Caughey Aaron B
Division of Perinatal Medicine & Genetics, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94143-0132, USA.
Am J Obstet Gynecol. 2006 May;194(5):e7-9. doi: 10.1016/j.ajog.2006.01.029.
The purpose of the study was to define predictors of successful rotation and rate of cesarean delivery after manual rotation of the fetal occiput from occiput posterior or transverse position.
A retrospective cohort study comprised patients who underwent a trial of manual rotation of the fetal occiput from occiput posterior or occiput transverse position. Successful rotation was defined as delivery in the occiput anterior position. We examined maternal, fetal, and labor characteristics as predictors of both fetal position at delivery and cesarean delivery.
Multiparity (odds ratio, 2.5; 95% CI, 1.5-3.8) and maternal age < 35 years (odds ratio, 2.0; 95% CI, 1.1-3.4) were associated with successful manual rotation of the fetal occiput. After successful rotation, the cesarean delivery rate was 2%, compared with 34% if the rotation failed (P < .001). Asian ethnicity, nulliparity, age > 35 years, labor induction, and epidural usage were associated with higher rates of cesarean delivery.
After successful manual rotation of the fetal occiput, women had lower cesarean delivery rates than women with unsuccessful rotations. Multiparity and maternal age of < 35 years were associated with more successful rotations.
本研究的目的是确定在将胎儿枕部从枕后位或枕横位手动旋转后成功旋转的预测因素及剖宫产率。
一项回顾性队列研究，纳入了接受胎儿枕部从枕后位或枕横位手动旋转试验的患者。成功旋转定义为以枕前位分娩。我们检查了产妇、胎儿和分娩特征，作为分娩时胎儿位置和剖宫产的预测因素。
经产妇（比值比，2.5；95%可信区间，1.5 - 3.8）和产妇年龄<35岁（比值比，2.0；95%可信区间，1.1 - 3.4）与胎儿枕部手动旋转成功相关。成功旋转后，剖宫产率为2%，而旋转失败时为34%（P <.001）。亚裔种族、初产妇、年龄>35岁、引产和硬膜外使用与较高的剖宫产率相关。
胎儿枕部手动旋转成功后，女性的剖宫产率低于旋转失败的女性。经产妇和产妇年龄<35岁与更成功的旋转相关。
