Kuppens Simone M I, Hutton Eileen K, Hasaart Tom H M, Aichi Nassira, Wijnen Henrica A, Pop Victor J M
Department of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, the Netherlands.
Department of Obstetrics and Gynaecology, McMaster University, Hamilton ON; Department of Midwifery Science VU Medical Center, Amsterdam, the Netherlands.
J Obstet Gynaecol Can. 2013 Oct;35(10):883-888. doi: 10.1016/S1701-2163(15)30809-4.
To compare the obstetric outcomes of pregnant women after successful external cephalic version (ECV) (cases) with a large group of pregnant women with a spontaneously occurring cephalic fetal position at delivery (controls).
We conducted a retrospective matched cohort study in a teaching hospital in the Netherlands. Delivery outcomes of women with a successful ECV were compared with those of women with spontaneously occurring cephalic presentations, controlling for maternal age, parity, gestational age at delivery, and onset of labour (spontaneous or induced). Exclusion criteria were a history of Caesarean section, delivery at < 35 weeks, and elective Caesarean section. The primary outcome was the prevalence of Caesarean section and instrumental delivery in both groups; secondary outcomes were the characteristics of cases requiring intervention such as Caesarean section or instrumental delivery.
Women who had a successful ECV had a significantly higher Caesarean section rate than the women in the control group (33/220 [15%] vs. 62/1030 [6.0 %]; P < 0.001). There was no difference in the incidence of instrumental delivery (20/220 [9.1%] vs. 103/1030 [10%]). Comparison of characteristics of women in the cases group showed that nulliparity, induction of labour, and occiput posterior presentation were associated with Caesarean section and instrumental deliveries.
Compared with delivery of spontaneous cephalic presenta-tions, delivery of cephalic presenting babies following successful ECV is associated with an increased rate of Caesarean section, especially in nulliparous women and women whose labour is induced.
比较成功实施外倒转术(ECV)的孕妇(病例组)与大量分娩时自然头位的孕妇(对照组)的产科结局。
我们在荷兰的一家教学医院进行了一项回顾性匹配队列研究。将成功实施ECV的女性的分娩结局与自然头位的女性的分娩结局进行比较,同时控制产妇年龄、产次、分娩时的孕周和分娩发动情况(自然发动或引产)。排除标准为剖宫产史、孕周<35周分娩以及选择性剖宫产。主要结局是两组剖宫产和器械助产的发生率;次要结局是需要干预(如剖宫产或器械助产)的病例特征。
成功实施ECV的女性剖宫产率显著高于对照组女性(33/220 [15%] 对比 62/1030 [6.0%];P<0.001)。器械助产的发生率没有差异(20/220 [9.1%] 对比 103/1030 [10%])。病例组女性特征的比较表明,初产、引产和枕后位与剖宫产和器械助产有关。
与自然头位分娩相比,成功实施ECV后头位胎儿的分娩剖宫产率增加,尤其是初产妇和引产的女性。