Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, 52621, Ramat Gan, Israel.
Tel Aviv University, Tel Aviv, Israel.
Arch Gynecol Obstet. 2020 Dec;302(6):1361-1367. doi: 10.1007/s00404-020-05733-w. Epub 2020 Aug 4.
The risk of cesarean delivery after a successful external cephalic version for breech presentation is higher as compared with fetuses in cephalic presentation. However, the role of the time interval between version attempt to delivery on the risk for cesarean delivery is unclear. We aimed to study the effect of the time interval from a successful external cephalic version to delivery on the risk for cesarean delivery and assess factors associated with cesarean delivery after a successful version.
We conducted a multicenter, retrospective cohort study, including all successful external cephalic version at two medical centers between 2011 and 2019. We compared patient baseline characteristics, obstetric characteristics, maternal and neonatal outcomes in women that delivered by vaginal delivery with those who delivered by cesarean delivery.
Overall, 769 deliveries were included. Of these, 98 women (12.7%) had cesarean delivery and 671 (87.3%) had vaginal delivery. Women who had cesarean delivery had a higher rate of obesity (44.9% vs 21.9%, p < 0.001; OR 2.88, CI 1.65-5.03) and nulliparity (45.9% vs 24.5%, p < 0.001; OR = 2.58, CI 1.67-3.98). The risk for intrapartum cesarean delivery did not differ according to time interval from external cephalic version to delivery.
The time interval between successful external cephalic version and delivery was not associated with mode of delivery. This finding is in contrast to previous reports. The risk for cesarean delivery after successful version is higher in nulliparous, obese women, and women whose weight gain in pregnancy was higher.
与头位胎儿相比，臀位经外倒转术（ECV）成功后的剖宫产风险更高。然而，ECV 尝试至分娩的时间间隔与剖宫产风险的关系尚不清楚。我们旨在研究从 ECV 成功到分娩的时间间隔对剖宫产风险的影响，并评估 ECV 成功后与剖宫产相关的因素。
我们进行了一项多中心回顾性队列研究，纳入了 2011 年至 2019 年在两个医疗中心进行的所有 ECV 成功病例。我们比较了经阴道分娩和剖宫产分娩的患者的基线特征、产科特征、母婴结局。
共纳入 769 例分娩。其中，98 例（12.7%）行剖宫产，671 例（87.3%）行阴道分娩。行剖宫产的患者肥胖率更高（44.9% vs 21.9%，p<0.001；OR 2.88，95%CI 1.65-5.03）和初产妇比例更高（45.9% vs 24.5%，p<0.001；OR=2.58，95%CI 1.67-3.98）。从 ECV 到分娩的时间间隔与产时剖宫产风险无关。
ECV 成功至分娩的时间间隔与分娩方式无关。这一发现与以往的报告不同。在初产妇、肥胖和妊娠体重增加较高的女性中，ECV 成功后剖宫产的风险更高。
