Weill Yishay, Pollack Raphael N
Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel.
Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel.
Aust N Z J Obstet Gynaecol. 2017 Jun;57(3):323-326. doi: 10.1111/ajo.12527. Epub 2016 Sep 14.
External cephalic version (ECV) in the presence of a uterine scar is still considered a relative contraindication despite encouraging studies of the efficacy and safety of this procedure. We present our experience with this patient population, which is the largest cohort published to date.
To evaluate the efficacy and safety of ECV in the setting of a prior caesarean delivery.
A total of 158 patients with a fetus presenting as breech, who had an unscarred uterus, had an ECV performed. Similarly, 158 patients with a fetus presenting as breech, and who had undergone a prior caesarean delivery also underwent an ECV. Outcomes were compared.
ECV was successfully performed in 136/158 (86.1%) patients in the control group. Of these patients, 6/136 (4.4%) delivered by caesarean delivery. In the study group, 117/158 (74.1%) patients had a successful ECV performed. Of these patients, 12/117 (10.3%) delivered by caesarean delivery. There were no significant complications in either of the groups.
ECV may be successfully performed in patients with a previous caesarean delivery. It is associated with a high success rate, and is not associated with an increase in complications.
尽管有关于外倒转术（ECV）有效性和安全性的鼓舞人心的研究，但子宫瘢痕存在时进行外倒转术仍被视为相对禁忌证。我们介绍了我们在这一患者群体中的经验，这是迄今为止发表的最大队列研究。
评估既往剖宫产史患者行外倒转术的有效性和安全性。
共有158例臀位胎儿且子宫无瘢痕的患者接受了外倒转术。同样，158例臀位胎儿且既往有剖宫产史的患者也接受了外倒转术。比较两组的结局。
对照组158例患者中有136例（86.1%）成功进行了外倒转术。其中，6例（4.4%）行剖宫产分娩。研究组中，158例患者中有117例（74.1%）成功进行了外倒转术。其中，12例（10.3%）行剖宫产分娩。两组均无显著并发症。
既往有剖宫产史的患者可以成功进行外倒转术。其成功率高，且不增加并发症。
