脐带特征与外倒转术结局的关系。

The relation between umbilical cord characteristics and the outcome of external cephalic version.

机构信息

Department of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, The Netherlands.

出版信息

Early Hum Dev. 2011 May;87(5):369-72. doi: 10.1016/j.earlhumdev.2011.02.003. Epub 2011 Feb 26.

DOI:10.1016/j.earlhumdev.2011.02.003

PMID:21354723

Abstract

BACKGROUND

Umbilical cords of fetuses in breech presentation differ in length and coiling from their cephalic counterparts and it might be hypothesised that these cord characteristics may in turn affect ECV outcome.

AIM

To investigate the relation between umbilical cord characteristics and the outcome of external cephalic version (ECV).

STUDY DESIGN

Prospective cohort study.

SUBJECTS

Women (>35 weeks gestation) with a singleton fetus in breech presentation, suitable for external cephalic version. Demographic, lifestyle and obstetrical parameters were assessed at intake. ECV success was based on cephalic presentation on ultrasound post-ECV. Umbilical cord length (UCL) and umbilical coiling index (UCI) were measured after birth.

OUTCOME MEASURE

The relation between umbilical cord characteristics (cord length and coiling) and the success of external cephalic version.

RESULTS

ECV success rate was overall 79/146 (54%), for multiparas 37/46(80%) and for nulliparas 42/100 (42%). Multiple logistic regression showed that UCL (OR: 1.04, CI: 1.01-1.07), nulliparity (OR: 0.20, CI: 0.08-0.51), frank breech (OR: 0.37, 95% CI: 0.15-0.90), body mass index (OR: 0.85, CI: 0.76-0.95), placenta anterior (OR: 0.27, CI: 0.12-0.63) and birth weight (OR: 1.002, CI: 1.001-1.003) were all independently related to ECV success.

CONCLUSIONS

Umbilical cord length is independently related to the outcome of ECV, whereas umbilical coiling index is not.

摘要

背景

臀位胎儿的脐带长度和缠绕方式与头位胎儿不同，因此可以假设这些脐带特征可能反过来影响外部胎儿倒转术（ECV）的结果。

目的

探讨脐带特征与外部胎儿倒转术（ECV）结果的关系。

研究设计

前瞻性队列研究。

研究对象

妊娠 35 周以上、臀位、适合外部胎儿倒转术的单胎孕妇。在入组时评估了人口统计学、生活方式和产科参数。ECV 成功的依据是 ECV 后超声显示的头位。分娩后测量脐带长度（UCL）和脐带缠绕指数（UCI）。

结果测量

脐带特征（脐带长度和缠绕）与 ECV 成功的关系。

结果

ECV 总成功率为 79/146（54%），多产妇为 37/46（80%），初产妇为 42/100（42%）。多因素逻辑回归显示，UCL（OR：1.04，95%CI：1.01-1.07）、初产妇（OR：0.20，95%CI：0.08-0.51）、完全臀位（OR：0.37，95%CI：0.15-0.90）、体质量指数（OR：0.85，95%CI：0.76-0.95）、胎盘前置（OR：0.27，95%CI：0.12-0.63）和出生体重（OR：1.002，95%CI：1.001-1.003）均与 ECV 成功独立相关。