Long J Q, Wei H W, Xia H W, Kong L, Song L, Yang Q L, Qin Y Q
Department of Obstetrics, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning 530003, China.
Zhonghua Fu Chan Ke Za Zhi. 2019 Aug 25;54(8):516-521. doi: 10.3760/cma.j.issn.0529-567x.2019.08.003.
To investigate the factors associated with the success rate of external cephalic version (ECV) for singleton and non-cephalic presentation pregnancies in the third trimester. A retrospective study of ECV among singleton and non-cephalic presentation pregnant women in 36-40 weeks of gestation at Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from January 2016 to June 2018 was analyzed. (1) Totally, 251 cases of 358 pregnant women who underwent ECV were successful, with a total success rate of 70.1% (251/358). The success rate of multipara was 79.1% (129/163), while 62.6% (122/195) in primipara (0.01). The total vaginal delivery rate was 52.2% (187/358), the vaginal delivery rate of multipara was 61.3% (100/163), while 44.6% (87/195) in primipara (0.01). (2) Spontaneous reversion occurred in 7.6%(19/251) of ECV successful women, the rate of reversion of multipara was 10.9% (14/129), higher than that of the primipara [4.1% (5/122); 0.01]. (3) Among the 232 pregnant women who did not reverted after successful ECV, 187 cases of successful vaginal delivery, the vaginal delivery rate was 80.6% (187/232); the vaginal delivery rate of the multipara was 87.0%(100/115), which was higher than that of the primipara [74.4%(87/117); 0.01]. (4) The variables significantly associated with ECV success were parity, type of breech, whether fetal presentation was in pelvic or not (all 0.05). The complication rate was 2.2% (8/358), among which the incidence of fetal distress, placental abruption and transient fetal heart abnormalities were 0.6% (2/358), 0.3% (1/358) and 1.4% (5/358) respectively. By close monitoring, ECV is a safe and effective procedure in selected appropriate cases, and worthy of clinical application.
探讨妊娠晚期单胎非头先露孕妇外倒转术（ECV）成功率的相关因素。对广西壮族自治区妇幼保健院2016年1月至2018年6月妊娠36 - 40周的单胎非头先露孕妇进行的ECV回顾性研究进行分析。（1）358例行ECV的孕妇中，共251例成功，总成功率为70.1%（251/358）。经产妇成功率为79.1%（129/163），初产妇为62.6%（122/195）（P<0.01）。总阴道分娩率为52.2%（187/358），经产妇阴道分娩率为61.3%（100/163），初产妇为44.6%（87/195）（P<0.01）。（2）ECV成功的孕妇中7.6%（19/251）发生自然回转，经产妇回转率为10.9%（14/129），高于初产妇[4.1%（5/122）；P<0.01]。（3）在ECV成功后未回转的232例孕妇中，187例成功阴道分娩，阴道分娩率为80.6%（187/232）；经产妇阴道分娩率为87.0%（100/115），高于初产妇[74.4%（87/117）；P<0.01]。（4）与ECV成功显著相关的变量为产次、臀位类型、胎儿先露是否入盆（均P<0.05）。并发症发生率为2.2%（8/358），其中胎儿窘迫、胎盘早剥和短暂性胎儿心脏异常的发生率分别为0.6%（2/358）、0.3%（1/358）和1.4%（5/358）。通过密切监测，在选择合适的病例中，ECV是一种安全有效的操作，值得临床应用。
