Sun Wen, Liu Fen, Liu Shiliang, Gratton Sara-Michelle, El-Chaar Darine, Wen Shi Wu, Chen Dunjin
Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical Centre for Critical Pregnant Women, Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China; OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Canada.
Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical Centre for Critical Pregnant Women, Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China.
Eur J Obstet Gynecol Reprod Biol. 2018 Mar;222:155-160. doi: 10.1016/j.ejogrb.2017.12.031. Epub 2017 Dec 16.
Few studies have assessed the impact of induction of labor on breech presentation. This study aims to summarize the effect of induction of labor of breech presentation on perinatal morbidity.
Literature review was done in Medline, Embase, Web of science and Cochrane Library up to 20 October 2017. Randomized control studies, cohort studies, and case control publishing studies comparing induction of labor versus spontaneous labor of singleton live breech birth were included. Perinatal morbidity was calculated by RevMan 5 and presented by pooled odds ratio with 95% confidence intervals.
Cesarean section rate and neonatal intensive care unit admission were increased in induction of breech labor as compared with spontaneous breech labor. No significant difference in umbilical cord blood base excess ≤ -12 mmol/L, Apgar 5 min < 7, Apgar 5 min < 4, umbilical cord blood PH < 7, neonatology unit admission, maternal fever, and intrapartum stillbirth between the two groups was found.
Induction of breech labor has higher cesarean section rate and NICU perinatal morbidity compared to spontaneous breech labor. The neonatal outcomes were otherwise similar across both groups. Eligibility for induction of breech labor needs to be assessed carefully according to individual situation.
很少有研究评估引产对臀位的影响。本研究旨在总结臀位引产对围产期发病率的影响。
截至2017年10月20日，在Medline、Embase、科学网和Cochrane图书馆进行文献综述。纳入比较单胎活产臀位分娩引产与自然分娩的随机对照研究、队列研究和病例对照发表研究。围产期发病率通过RevMan 5计算，并以合并比值比及95%置信区间表示。
与自然臀位分娩相比，臀位引产的剖宫产率和新生儿重症监护病房入院率增加。两组在脐血碱剩余≤-12 mmol/L、5分钟阿氏评分<7、5分钟阿氏评分<4、脐血pH<7、新生儿科入院、产妇发热和产时死产方面未发现显著差异。
与自然臀位分娩相比，臀位引产的剖宫产率和新生儿重症监护病房围产期发病率更高。两组的新生儿结局在其他方面相似。需要根据个体情况仔细评估臀位引产的适应证。
