Yamamura Yasuko, Ramin Kirk D, Ramin Susan M
Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota, USA.
Clin Obstet Gynecol. 2007 Jun;50(2):526-36. doi: 10.1097/GRF.0b013e31804c9d24.
Breech presentation occurs at term in approximately 3% to 4% of singleton gestations. This presentation is associated with a variety of maternal and fetal conditions including preterm labor, abnormal amniotic fluid volume, hydrocephaly, anencephaly, mullerian anomalies, abnormal placentation, and multifetal gestation. Cesarean delivery has been associated with increased risk of subsequent accreta, placenta previa, hemorrhage, and hysterectomy. The Term Breech Trial initially suggested that planned vaginal breech delivery is associated with increased neonatal morbidity and mortality compared with planned cesarean delivery. Long-term follow-up of these vaginally delivered infants contradict the initial findings. Current debate surrounds the dilemma of whether the untoward complications of cesarean delivery are warranted given uncertain minimal increases in neonatal survival and improvement in neurologic outcome with planned cesarean.
臀位分娩在足月单胎妊娠中发生率约为3%至4%。这种胎位与多种母体和胎儿状况相关，包括早产、羊水异常、脑积水、无脑儿、苗勒管畸形、胎盘异常和多胎妊娠。剖宫产与后续胎盘植入、前置胎盘、出血和子宫切除的风险增加有关。足月臀位试验最初表明，与计划剖宫产相比，计划阴道臀位分娩会增加新生儿发病率和死亡率。对这些经阴道分娩婴儿的长期随访与最初的研究结果相矛盾。目前的争论围绕着一个两难问题：鉴于计划剖宫产在新生儿存活率和神经学结局改善方面的最小增加不确定，剖宫产的不良并发症是否合理。
