de Gregorio Nikolaus, Friedl Thomas, Schramm Amelie, Reister Frank, Janni Wolfgang, Ebner Florian
Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany.
Gynecol Obstet Invest. 2018;83(5):477-481. doi: 10.1159/000480013. Epub 2017 Aug 25.
Achieving a cephalic position after a successful external cephalic version (ECV) is desired to result in delivery and fetal outcomes that are similar to those of deliveries following spontaneous cephalic presentation.
We performed a retrospective cohort study including patients with successful ECV following fetal breech position (ECV cohort, n = 47) or with a singleton spontaneous cephalic pregnancy at ≥37 weeks of gestational age (control group, n = 7,456) attempting a vaginal delivery between 2010 and 2013 at the University Hospital Ulm. The mode of delivery and fetal outcome parameters were compared between these 2 groups using nonparametric statistics.
ECV cohort and control group did not differ with respect to maternal age, parity, gestational age at birth, and fetal gender. There were no significant differences between the 2 groups with regard to all parameters indicating fetal outcome. However, the rate of cesarean sections was higher after successful ECV compared to spontaneous cephalic presentation (27.7 vs. 12.8%, OR 2.615).
While vaginal delivery is less likely to happen after a successful ECV compared to spontaneous cephalic singleton pregnancies, fetal outcome parameters showed no difference between the 2 groups. Physicians should be counseling and encouraging women to attempt ECV, as it is a safe and effective procedure.
成功实施外倒转术（ECV）后实现头先露，有望获得与自然头先露分娩相似的分娩方式及胎儿结局。
我们进行了一项回顾性队列研究，纳入2010年至2013年在乌尔姆大学医院尝试经阴道分娩的胎儿臀位成功实施ECV的患者（ECV队列，n = 47）或孕龄≥37周的单胎自然头先露妊娠患者（对照组，n = 7456）。使用非参数统计方法比较这两组的分娩方式和胎儿结局参数。
ECV队列和对照组在产妇年龄、产次、出生时孕周及胎儿性别方面无差异。两组在所有表明胎儿结局的参数方面均无显著差异。然而，与自然头先露相比，成功实施ECV后的剖宫产率更高（27.7% 对12.8%，OR 2.615）。
与单胎自然头先露妊娠相比，成功实施ECV后经阴道分娩的可能性较小，但两组的胎儿结局参数无差异。医生应向女性提供咨询并鼓励她们尝试ECV，因为这是一种安全有效的方法。
