Impey Olivia R E, Greenwood Catherine E L, Impey Lawrence W M
University of Edinburgh Medical School, United Kingdom.
Oxford Fetal Medicine Unit, Level 6, Women's Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, United Kingdom.
Eur J Obstet Gynecol Reprod Biol. 2018 Dec;231:210-213. doi: 10.1016/j.ejogrb.2018.10.036. Epub 2018 Oct 22.
External cephalic version is commonly not performed in women with a previous cesarean section. Fear of uterine rupture and cesarean section in labor are prominent. The risks, however, of these are unclear. This study aims to document the safety and efficacy of external cephalic version in women with a prior cesarean section in a series of 100 consecutive attempts, and to perform a literature of the existing literature.
This is a retrospective cohort study of prospectively collected data of external cephalic version attempts in women at term with a previous cesarean section, and a literature review of previously published series. External cephalic version was performed by one of 3 experienced operators, with salbutamol tocolysis if appropriate, using ultrasound to visualize the fetal heart and place of fetal parts.
100 women with a prior cesarean section underwent external cephalic version over a 16-year period in one institution. 68% had no previous vaginal delivery. The external cephalic version success rate was 50%, and 30 (63.8%) of these subsequently delivered vaginally. There were no cases of uterine rupture or other complications. A literature review of series containing a total of 549 cases revealed no cases of uterine rupture or perinatal death.
External cephalic version in women with a prior cesarean section is safe but enables a vaginal birth in only about a third of women.
既往有剖宫产史的女性通常不进行外倒转术。对子宫破裂和分娩时剖宫产的担忧较为突出。然而，这些情况的风险尚不清楚。本研究旨在记录连续100次尝试对既往有剖宫产史的女性进行外倒转术的安全性和有效性，并对现有文献进行综述。
这是一项回顾性队列研究，对既往有剖宫产史的足月女性外倒转术尝试的前瞻性收集数据进行研究，并对先前发表的系列文献进行综述。外倒转术由3名经验丰富的操作人员之一进行，必要时使用沙丁胺醇进行宫缩抑制，利用超声观察胎儿心脏及胎儿各部位位置。
在一所机构中，100名既往有剖宫产史的女性在16年期间接受了外倒转术。68%的女性既往无阴道分娩史。外倒转术成功率为50%，其中30例（63.8%）随后经阴道分娩。无子宫破裂或其他并发症发生。对总共包含549例病例的系列文献综述显示，无子宫破裂或围产期死亡病例。
既往有剖宫产史的女性进行外倒转术是安全的，但仅约三分之一的女性能够经阴道分娩。
