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经阴道外倒转术——臀位分娩的机会。

External Cephalic Version-A Chance for Vaginal Delivery at Breech Presentation.

机构信息

Clinic of Obstetrics and Gynecology, Diakoneo Diak Klinikum Schwäbisch Hall, Diakoniestrasse 10, 74523 Schwäbisch Hall, Germany.

Clinic of Internal Medicine, Hohenloher Krankenhaus Öhringen, 74613 Öhringen, Germany.

出版信息

Medicina (Kaunas). 2022 Nov 10;58(11):1619. doi: 10.3390/medicina58111619.

Abstract

: In recent years, the rate of caesarean section (CS) has increased constantly. Although vaginal breech delivery has a long history, breech presentation has become the third most common indication for CS. This study aims to identify factors associated with the success of external cephalic version (ECV), underline the success rate of ECV for breech presentation and highlight the high rate of vaginal delivery after successful ECV. : This retrospective observational study included 113 patients with singleton fetuses in breech presentation, who underwent ECV from January 2016 to March 2021 in the Clinic of Obstetrics and Gynecology, Diakonieklinikum Schwäbisch Hall, Germany. Maternal and fetal parameters and data related to procedure and delivery were collected. Possible predictors of successful ECV were evaluated. : The success rate of ECV was 54.9%. The overall rate of vaginal birth was 44.2%, regardless of ECV outcome. The vaginal birth rate after successful ECV was 80.6%. Overall, 79.0% of women with successful ECV delivered spontaneously without complications, 19.4% delivered through CS performed during labor by medical necessity, and 1.6% delivered through vacuum extraction. ECV was performed successfully in three of the four women with history of CS. Gravidity, parity, maternal age, gestational age, fetal weight, and amniotic fluid index (AFI) were significantly correlated with the outcome of ECV. : ECV for breech presentation is a safe procedure with a good success rate, thus increasing the proportion of vaginal births. Maternal and fetal parameters can be used to estimate the chances of successful ECV.

摘要

近年来,剖宫产率(CS)不断上升。尽管阴道臀位分娩历史悠久,但臀位已成为 CS 的第三大常见指征。本研究旨在确定与外部胎儿头位倒转术(ECV)成功相关的因素,强调臀位行 ECV 的成功率,并突出 ECV 成功后阴道分娩率高。

本回顾性观察研究纳入了 2016 年 1 月至 2021 年 3 月期间在德国施瓦本哈尔迪亚科尼希库林克妇产科诊所接受 ECV 的 113 例单胎臀位胎儿患者。收集了产妇和胎儿参数以及与手术和分娩相关的数据。评估了 ECV 成功的可能预测因素。

ECV 的成功率为 54.9%。无论 ECV 结果如何,阴道分娩率总体为 44.2%。ECV 成功后的阴道分娩率为 80.6%。总体而言,79.0%的 ECV 成功的妇女自然分娩,无并发症,19.4%的妇女因医学需要在分娩时行 CS 分娩,1.6%的妇女行真空抽吸分娩。有 CS 史的 4 名妇女中有 3 名 ECV 成功。孕次、产次、产妇年龄、孕周、胎儿体重和羊水指数(AFI)与 ECV 结果显著相关。

对于臀位,ECV 是一种安全的手术,成功率较高,从而增加了阴道分娩的比例。可以使用产妇和胎儿参数来估计 ECV 成功的机会。

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Predictors for a successful external cephalic version: a single centre experience.外倒转术成功的预测因素:单中心经验
Arch Gynecol Obstet. 2016 Apr;293(4):749-55. doi: 10.1007/s00404-015-3902-z. Epub 2015 Oct 5.

本文引用的文献

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External cephalic version - A 10-year review of practice.外倒转术——十年实践回顾
Eur J Obstet Gynecol Reprod Biol. 2021 Mar;258:414-417. doi: 10.1016/j.ejogrb.2021.01.044. Epub 2021 Jan 29.
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Current Approach for External Cephalic Version in Germany.德国目前的外倒转术方法。
Geburtshilfe Frauenheilkd. 2020 Oct;80(10):1041-1047. doi: 10.1055/a-1127-8646. Epub 2020 Sep 25.

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