KNOV, Royal Dutch Organisation of Midwives, Utrecht, the Netherlands.
TNO Department of Child Health, Leiden, the Netherlands.
BJOG. 2016 Feb;123(3):415-23. doi: 10.1111/1471-0528.13234. Epub 2015 Feb 2.
To evaluate the success of an external cephalic version (ECV) training programme, and to determine the rates of successful ECV, complications, and caesarean birth in a low-risk population.
Prospective observational study.
Primary health care and hospital settings throughout the Netherlands (January 2008-September 2011).
Low-risk women with a singleton fetus in breech presentation, without contraindications to ECV, were offered ECV at approximately 36 weeks of gestation.
Data were collected for all ECVs performed by midwives, and were entered into a national online database.
Successful ECV was defined as the fetus having a cephalic presentation immediately following the procedure and at birth. Complications were observed at ≤ 30 minutes and between 30 minutes and 48 hours after the ECV procedure. All serious pregnancy outcomes that occurred after the ECV procedure until birth were reported.
A total of 47% had a successful ECv and a cephalic at the time of birth: 34% of nulliparous and 66% of multiparous women. After ECV, 57% of women gave birth vaginally: 45% of nulliparous women and 76% of multiparous women. Within 30 minutes after ECV, and between 30 minutes and 48 hours after ECV, the proportion of women experiencing a complication or serious pregnancy outcome was 0.9% and 1.8%, respectively. Serious pregnancy outcome at any time following ECV until birth was experienced by 58 (2.5%) of the women.
The success rate of ECVs performed by trained midwives in primary health care or hospital settings is comparable with that of other providers, and the procedure is safe for low-risk women.
评估外部头位倒转术（ECV）培训计划的成功率，并确定低危人群中 ECV 的成功率、并发症和剖宫产率。
前瞻性观察研究。
荷兰各地的初级保健和医院（2008 年 1 月至 2011 年 9 月）。
有臀位单胎且无 ECV 禁忌证的低危孕妇，在大约 36 孕周时接受 ECV。
由助产士收集所有 ECV 的数据，并输入国家在线数据库。
ECV 后胎儿立即呈头位且在分娩时呈头位定义为 ECV 成功。并发症在 ECV 后≤30 分钟和 30 分钟至 48 小时观察。报告 ECV 后直至分娩时发生的所有严重妊娠结局。
共有 47%的孕妇 ECV 成功且在分娩时呈头位：初产妇占 34%，经产妇占 66%。ECV 后，57%的孕妇经阴道分娩：初产妇占 45%，经产妇占 76%。ECV 后 30 分钟内和 30 分钟至 48 小时内，分别有 0.9%和 1.8%的孕妇发生并发症或严重妊娠结局。ECV 后至分娩时任何时间发生严重妊娠结局的孕妇有 58 例（2.5%）。
在初级保健或医院环境中由训练有素的助产士进行的 ECV 成功率与其他提供者相当，该程序对低危孕妇是安全的。
