Rabin Medical Center, Helen Schneider Hospital for Women, Petach Tikva, Israel.
The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Birth. 2019 Dec;46(4):623-627. doi: 10.1111/birt.12458. Epub 2019 Oct 14.
External cephalic version (ECV) is a common procedure for women carrying a breech-presenting fetus, in an effort to avoid a cesarean birth. The benefit of immediate labor induction after ECV vs. expectant management is undetermined. We aimed to evaluate whether induction of labor immediately after a successful ECV improves the chances of a vaginal delivery compared with expectant management.
Retrospective analysis of 296 women who underwent successful ECV performed in term singleton gestations (2007-2018) in the Rabin Medical Center. Mode of delivery and other obstetrical and neonatal outcomes were compared between women undergoing immediate labor induction after ECV and those managed expectantly.
Of 296 women after successful ECVs, 54 (18.2%) underwent immediate labor induction and 242 (81.8%) were managed expectantly. Immediate induction was associated with higher parity (2.4 vs 1.7, P = .03) and lower mean birthweight (3128 vs 3346 g, P < .01). Mode of delivery was similar between groups, and no other significant differences in obstetrical and neonatal adverse outcomes were noted.
In our cohort, immediate labor induction after successful ECV apparently had no benefits in terms of obstetrical or neonatal complications, and did not reduce the risk of cesarean birth. Therefore, expectant management seems reasonable and safe.
外倒转术（ECV）是一种常见的方法，用于处理臀位胎儿的孕妇，以避免剖宫产。ECV 后立即引产与期待管理相比是否能提高阴道分娩的机会，目前尚未确定。我们旨在评估在成功进行 ECV 后立即引产是否能提高阴道分娩的机会，与期待管理相比。
对在拉宾医学中心进行的 296 例足月单胎妊娠（2007-2018 年）成功 ECV 的妇女进行回顾性分析。比较 ECV 后立即进行分娩诱导的妇女和期待管理的妇女的分娩方式和其他产科及新生儿结局。
在 296 例成功 ECV 后，54 例（18.2%）立即进行了引产，242 例（81.8%）进行了期待管理。立即引产与更高的产次（2.4 对 1.7，P=.03）和更低的平均出生体重（3128 对 3346 克，P<.01）相关。两组的分娩方式相似，且在产科和新生儿不良结局方面没有其他显著差异。
在我们的队列中，成功 ECV 后立即进行引产在产科或新生儿并发症方面显然没有益处，也不能降低剖宫产的风险。因此，期待管理似乎是合理和安全的。
