外倒转术之后的分娩时机与剖宫产风险。

Timing of delivery after external cephalic version and the risk for cesarean delivery.

机构信息

From the Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel.

出版信息

Obstet Gynecol. 2011 Aug;118(2 Pt 1):209-213. doi: 10.1097/AOG.0b013e31822545a9.

DOI:10.1097/AOG.0b013e31822545a9

PMID:21775835

Abstract

OBJECTIVE

To estimate the association between time of delivery after external cephalic version at term and the risk for cesarean delivery.

METHODS

This retrospective cohort study included all successful external cephalic versions performed in a tertiary center between January 1997 and January 2010. Stepwise logistic regression was used to calculate the odds ratio (OR) for cesarean delivery.

RESULTS

We included 483 external cephalic versions in this study, representing 53.1% of all external cephalic version attempts. The incidence of cesarean delivery for 139 women (29%) who gave birth less than 96 hours from external cephalic version was 16.5%; for 344 women (71%) who gave birth greater than 96 hours from external cephalic version, the incidence of cesarean delivery was 7.8% (P = .004). The adjusted OR for cesarean delivery was 2.541 (95% confidence interval 1.36-4.72). When stratified by parity, the risk for cesarean delivery when delivery occurred less than 96 hours after external cephalic version was 2.97 and 2.28 for nulliparous and multiparous women, respectively.

CONCLUSION

Delivery at less than 96 hours after successful external cephalic version was associated with an increased risk for cesarean delivery.

LEVEL OF EVIDENCE

III.

摘要

目的

评估足月行外倒转术（ECV）后分娩时间与剖宫产风险之间的关联。

方法

本回顾性队列研究纳入了 1997 年 1 月至 2010 年 1 月期间在一家三级中心成功进行的所有外倒转术。采用逐步逻辑回归计算剖宫产的比值比（OR）。

结果

本研究共纳入 483 例外倒转术，占所有外倒转术尝试的 53.1%。在分娩距外倒转术不到 96 小时的 139 名女性（29%）中，剖宫产的发生率为 16.5%；在分娩距外倒转术大于 96 小时的 344 名女性（71%）中，剖宫产的发生率为 7.8%（P=0.004）。剖宫产的调整 OR 为 2.541（95%置信区间 1.36-4.72）。按产次分层时，外倒转术后 96 小时内分娩的剖宫产风险在初产妇中为 2.97，在经产妇中为 2.28。