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评估成功的外倒转术预后参数对最终分娩方式的影响。

Assessment of the Successful External Cephalic Version Prognostic Parameters Effect on Final Mode of Delivery.

作者信息

Felemban Asalah S, Arab Kholoud, Algarawi Asmaa, Abdulghaffar Shahad K, Aljahdali Khadijah M, Alotaifi Malak A, Bafail Sumayya A, Bakhudayd Tasneem M

机构信息

Medicine, King Abdulaziz University Hospital, Jeddah, SAU.

Obstetrics and Gynecology, King Abdulaziz University Hospital, Jeddah, SAU.

出版信息

Cureus. 2021 Jul 26;13(7):e16637. doi: 10.7759/cureus.16637. eCollection 2021 Jul.

Abstract

Aim This study aims to evaluate the prognostic parameters of successful approach for an external cephalic version (ECV) procedure by considering the vaginal delivery as the optimal mode of delivery. Methodology A retrospective cohort study was done during June 2019 in the obstetrics and gynecology department at King Abdulaziz University Hospital. Data were collected between May 2009 and May 2019 and included all pregnant women who were candidates for the ECV. The primary objective was to assess the final mode of delivery in relation to the outcome of ECV followed by the secondary objective which was the prognostic parameters of the ECV procedure (body mass index, amniotic fluid index, parity, estimated fetal weight). Additional variables were maternal age, placental position and ethnicity. Results We have studied 86 pregnant women with ECV attempts the overall ECV success rate was for 46 women (59.7%). For the final mode of delivery, after a successful ECV procedure, 40 women (87%) whom had spontaneous vaginal delivery, in association to successful ECV, the prognostic parameters recorded the highest success rate were multiparous 35 (76.1%), body mass index between 25 and 29.9 (53.1%), women older than 30 years old (60.9%), gestational age between 37 to 39.6 weeks (56.5%). Posterior placental location 55.6%, estimated fetal weight more than 2500 (73.9%). Conclusion Successful ECV cases have recorded a significant increase in the incidence of spontaneous vaginal delivery and the outcome of ECV which is affected by many prognostic parameters such as parity, maternal age, gestational age, body mass index, amniotic fluid index (AFI) and estimated fetal weight (EFW).

摘要

目的 本研究旨在通过将阴道分娩视为最佳分娩方式,评估外倒转术(ECV)成功实施的预后参数。方法 2019年6月在阿卜杜勒阿齐兹国王大学医院妇产科进行了一项回顾性队列研究。收集了2009年5月至2019年5月期间的数据,包括所有符合ECV条件的孕妇。主要目标是评估与ECV结果相关的最终分娩方式,其次要目标是ECV手术的预后参数(体重指数、羊水指数、产次、估计胎儿体重)。其他变量包括产妇年龄、胎盘位置和种族。结果 我们研究了86例尝试ECV的孕妇,总体ECV成功率为46例(59.7%)。对于最终分娩方式,在成功实施ECV手术后,40例(87%)孕妇自然阴道分娩,与成功的ECV相关,记录的预后参数成功率最高的是经产妇35例(76.1%)、体重指数在25至29.9之间(53.1%)、年龄大于30岁的女性(60.9%)、孕周在37至39.6周之间(56.5%)。胎盘后位55.6%、估计胎儿体重超过2500(73.9%)。结论 成功的ECV病例记录显示自然阴道分娩的发生率显著增加,且ECV的结果受许多预后参数影响,如产次、产妇年龄、孕周、体重指数、羊水指数(AFI)和估计胎儿体重(EFW)。

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本文引用的文献

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Success rates of early versus late initiation of external cephalic version.早期与晚期行外倒转术的成功率比较。
Int J Gynaecol Obstet. 2019 Apr;145(1):116-121. doi: 10.1002/ijgo.12774. Epub 2019 Feb 18.
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The impact of maternal body mass index on external cephalic version success.孕妇体重指数对胎位外倒转术成功率的影响。
J Matern Fetal Neonatal Med. 2019 Jul;32(13):2159-2165. doi: 10.1080/14767058.2018.1427721. Epub 2018 Jan 21.
10
Cephalic version by postural management for breech presentation.通过体位管理进行臀位的头位转位。
Cochrane Database Syst Rev. 2012 Oct 17;10(10):CD000051. doi: 10.1002/14651858.CD000051.pub2.

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