Policiano Catarina, Costa Ana, Valentim-Lourenço Alexandre, Clode Nuno, Graça Luís M
Department of Obstetrics and Gynecology, Central Hospital of Lisbon North, Hospital of Santa Maria, Lisbon, Portugal.
Department of Obstetrics and Gynecology, Central Hospital of Lisbon North, Hospital of Santa Maria, Lisbon, Portugal.
Int J Gynaecol Obstet. 2014 Sep;126(3):272-4. doi: 10.1016/j.ijgo.2014.03.029. Epub 2014 May 14.
To evaluate the delivery route and the indications for cesarean delivery after successful external cephalic version (ECV).
A retrospective matched case-control study was conducted at a hospital in Lisbon, Portugal, between 2002 and 2012. Each woman who underwent successful ECV (n = 44) was compared with the previous and next women who presented for labor management and who had the same parity and a singleton vertex pregnancy at term (n = 88). The outcome measures were route of delivery, indications for cesarean delivery, and incidence of nonreassuring fetal status.
Attempts at ECV were successful in 62 (46%) of 134 women, and 44 women whose fetuses remained in a cephalic presentation until delivery were included in the study. The rates of intrapartum cesarean delivery and operative vaginal delivery did not differ significantly between cases and controls (intrapartum cesarean delivery, 9 [20%] vs 16 [18%], P = 0.75; operative vaginal delivery, 14 [32%] vs 19 [22%], P = 0.20). The indications for cesarean delivery after successful ECV did not differ; in both groups, cesarean delivery was mainly performed for labor arrest disorders (cases, 6 [67%] vs controls, 13 [81%]; P = 0.63).
Successful ECV was not associated with increased rates of intrapartum cesarean delivery or operative vaginal delivery.
评估外倒转术(ECV)成功后的分娩方式及剖宫产指征。
2002年至2012年在葡萄牙里斯本的一家医院进行了一项回顾性配对病例对照研究。将每例接受成功ECV的女性(n = 44)与之前和之后前来分娩管理且孕周相同、单胎头位妊娠、产次相同的女性(n = 88)进行比较。观察指标为分娩方式、剖宫产指征及胎儿窘迫发生率。
134例女性中62例(46%)外倒转术尝试成功,44例胎儿直至分娩时仍为头位的女性纳入研究。病例组和对照组的产时剖宫产率和阴道助产率无显著差异(产时剖宫产率,9例[20%]对16例[18%],P = 0.75;阴道助产率,14例[32%]对19例[22%],P = 0.20)。ECV成功后的剖宫产指征无差异;两组剖宫产主要因产程停滞(病例组6例[67%]对对照组13例[81%];P = 0.63)。
成功的ECV与产时剖宫产率或阴道助产率增加无关。