Flamm B L, Fried M W, Lonky N M, Giles W S
Department of Obstetrics and Gynecology, Kaiser Permanente Medical Centers, Los Angeles, Riverside, CA 92505.
Am J Obstet Gynecol. 1991 Aug;165(2):370-2. doi: 10.1016/0002-9378(91)90095-9.
Approximately 100,000 cesarean sections are performed each year in the United States because of breech presentation. Numerous studies have shown that external cephalic version can eliminate the need for many of these operations. However, because of the fear of uterine rupture, these studies have generally excluded patients who have undergone previous cesarean section. To evaluate the validity of this exclusion policy, we studied patients with one or more previous cesarean sections and breach presentations near term. Version attempts were successful in 82% of 56 patients who had undergone a previous cesarean section. Sixty-five percent of the successful version patients went on to have vaginal birth after cesarean section. There were no serious maternal or fetal complications associated with the version attempts. We conclude that external cephalic version is a reasonable option in patients with prior low transverse cesarean section.
在美国，每年约有10万例剖宫产手术是因为臀位分娩而进行的。大量研究表明，外倒转术可以避免许多此类手术。然而，由于担心子宫破裂，这些研究通常将既往有剖宫产史的患者排除在外。为了评估这种排除政策的合理性，我们研究了有一次或多次既往剖宫产史且接近足月臀位的患者。在56例有既往剖宫产史的患者中，82%的外倒转术尝试成功。成功进行外倒转术的患者中有65%随后进行了剖宫产术后阴道分娩。外倒转术尝试未出现严重的母体或胎儿并发症。我们得出结论，对于既往有低位横切口剖宫产史的患者，外倒转术是一种合理的选择。
