Levin Gabriel, Rottenstreich Amihai, Meyer Raanan, Weill Yishay, Pollack Raphael N
Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Department of Obstetrics and Gynecology, Chaim Sheba, Ramat Gan, Afilliated to Tel-Aviv university, Tel-Aviv, Israel.
J Perinat Med. 2020 Aug 18;49(1):30-35. doi: 10.1515/jpm-2020-0290.
Current literature evaluating the role of induction of labor (IOL) following successful external cephalic version (ECV) attempt as compared to expectant management is limited. We aim to assess the risk of cesarean delivery in those undergoing immediate IOL following successful ECV as compared to those who were expectantly managed.
A retrospective cohort study of successful external cephalic versions. The study group included 57 women that were induced after procedure in the lack of maternal or fetal indications for induction of labor. These women were compared to 341 expectantly managed women. Maternal and fetal characteristics and outcomes were compared.
Gestation age at delivery was higher among the expectant management group (401/7 vs. 384/7, median, p=0.002) as compared to the induction group. Cesarean delivery rates were similar between both groups (28 [8.2%] vs. 3 [5.3%], p=0.44). In a multivariate logistic regression analysis, only nulliparity was significantly associated with cesarean delivery (adjusted odds ratio 3.42, confidence interval 1.61-7.24, p=0.001). No correlation was found between the version-to-delivery interval and the risk for cesarean delivery.
Induction of labor after successful ECV was not shown to influence cesarean delivery rates. As immediate IOL may result in higher rate of early-term deliveries, and in light of the lack of clinical benefit, we advocate against elective IOL following successful ECV.
与期待管理相比，目前评估成功的外倒转术（ECV）尝试后引产（IOL）作用的文献有限。我们旨在评估与接受期待管理的患者相比，成功进行ECV后立即进行IOL的患者剖宫产的风险。
一项关于成功外倒转术的回顾性队列研究。研究组包括57名在无引产的母体或胎儿指征情况下术后接受引产的女性。将这些女性与341名接受期待管理的女性进行比较。比较母体和胎儿特征及结局。
与引产组相比，期待管理组的分娩孕周更高（中位数40 1/7周对38 4/7周，p = 0.002）。两组的剖宫产率相似（28例[8.2%]对3例[5.3%]，p = 0.44）。在多因素逻辑回归分析中，只有初产与剖宫产显著相关（调整后的优势比3.42，置信区间1.61 - 7.24，p = 0.001）。未发现倒转至分娩间隔与剖宫产风险之间存在相关性。
未显示成功进行ECV后引产会影响剖宫产率。由于立即进行IOL可能导致早产率更高，且鉴于缺乏临床益处，我们主张反对在成功进行ECV后进行选择性IOL。
