Rabinovici J, Barkai G, Shalev J, Serr D M, Mashiach S
Isr J Med Sci. 1986 Jan;22(1):34-40.
We present our experience with 60 trials of external cephalic version under tocolysis (EVT) performed on 58 women with uncomplicated (low-risk) pregnancies at term (37 to 42 weeks) during a 10-month period. Version was successful in 67.2% of the subjects (70.7% of trials). Fetal well-being was monitored before, during and after the procedure by cardiotocography and real-time ultrasound (RTUS). No analgetic or anesthetic medication was administered. Transient fetal bradycardia was recorded in 18 women. No major complications were noted. Compared with the period preceding the protocol, the breech rate declined during the study period by 1.02% (P less than 0.02) with a parallel decline of 1.12% (P less than 0.001) in the low-risk breech group affected by the protocol. The cesarean section rate for low-risk breeches fell from 1.85 to 0.89% (P less than 0.001), while the overall cesarean section rate decreased from 10.15 to 9.1% (not significant). We conclude from our experience and previous studies that EVT/RTUS is a reasonable alternative in the management of pathological presentations near term, provided that only low-risk pregnancies are included, and analgesia or anesthesia for external version under tocolysis is avoided.
我们介绍了在10个月期间，对58例足月（37至42周）无并发症（低风险）妊娠的妇女进行60次宫缩抑制剂下外倒转术（EVT）的经验。外倒转术在67.2%的受试者中成功（70.7%的尝试成功）。在手术前、手术期间和手术后通过胎心监护和实时超声（RTUS）监测胎儿健康状况。未给予镇痛或麻醉药物。18名妇女记录到短暂性胎儿心动过缓。未观察到重大并发症。与方案实施前的时期相比，研究期间臀位率下降了1.02%（P<0.02），受该方案影响的低风险臀位组平行下降了1.12%（P<0.001）。低风险臀位剖宫产率从1.85%降至0.89%（P<0.001），而总体剖宫产率从10.15%降至9.1%（无统计学意义）。根据我们的经验和先前的研究，我们得出结论，在仅纳入低风险妊娠且避免宫缩抑制剂下外倒转术的镇痛或麻醉的情况下，EVT/RTUS是近足月病理胎位处理的合理替代方法。
