Han Jun, Wang Shuai, Ding Mei
Department of Obstetrics, Guangzhou Hospital of Integrated Traditional and Western Medicine, Guangzhou, 510800, People's Republic of China.
Department of Critical Care Medicine, Guangzhou Hospital of Integrated Traditional and Western Medicine, Guangzhou, 510800, People's Republic of China.
Int J Womens Health. 2023 Dec 11;15:1941-1949. doi: 10.2147/IJWH.S428946. eCollection 2023.
We explored the feasibility and safety of external cephalic version (ECV) for cases of breech presentation.
We retrospectively analyzed data from 158 singleton pregnant women with breech presentation at 36 weeks gestation, admitted to Guangzhou Hospital of Integrated Traditional and Western Medicine from January 2018 to March 2022. 42 underwent ECV, categorized as the ECV group, while 116 without ECV comprised the control group. Systematic collection and evaluation of pregnancy outcomes were conducted for both groups.
Within the control group, 16 cases experienced a spontaneous transition to head presentation, among which 14 cases resulted in successful vaginal deliveries. In 2 cases, cesarean deliveries were performed due to fetal macrosomia and persistent posterior occipital presentation. Furthermore, 2 cases of breech presentation in pregnant women were successfully delivered vaginally through breech traction, necessitating an emergency procedure due to the wide opening of the uterus. Within the ECV group, 28 cases were successfully inverted to the cephalic presentation. Among them, 1 case underwent an emergency cesarean delivery due to fetal distress during cephalic delivery, 3 cases required cesarean deliveries due to abnormal labor, and 24 cases were successfully delivered vaginally. The comparative analyses showed that the cesarean section rate (18/42 vs 100/116) and non-cephalic delivery rate (14/42 vs 100/116) in the ECV group were significantly lower than those in the control group ( < 0.001). There was no statistically significant differences between the two groups with respect to the rate of newborns with Apgar score < 7 (1/42 vs 3/116), premature rupture of membrane (3/42 vs 20/116), acute fetal distress (2/42 vs 2/116), and cord prolapse (0/42 vs 1/116) ( > 0.05).
ECV can effectively reduce the rate of cesarean delivery and non-cephalic deliveries. However, it but requires strict adherence to indications and continuous monitoring.
探讨外倒转术（ECV）用于臀位妊娠的可行性和安全性。
回顾性分析2018年1月至2022年3月在广州中西医结合医院收治的158例妊娠36周单胎臀位孕妇的数据。42例行ECV，分为ECV组，116例未行ECV的孕妇作为对照组。对两组妊娠结局进行系统收集和评估。
对照组中，16例自然转为头位，其中14例经阴道成功分娩。2例因胎儿巨大和持续性枕后位行剖宫产。此外，2例臀位孕妇经臀牵引成功经阴道分娩，因子宫口开大而行急诊手术。ECV组中，28例成功转为头位。其中，1例因头位分娩时胎儿窘迫行急诊剖宫产，3例因产程异常行剖宫产，24例经阴道成功分娩。比较分析显示，ECV组剖宫产率（18/42 vs 100/116）和非头位分娩率（14/42 vs 100/116）显著低于对照组（<0.001）。两组新生儿Apgar评分<7分率（1/42 vs 3/116）、胎膜早破率（3/42 vs 20/116）、急性胎儿窘迫率（2/42 vs 2/116）和脐带脱垂率（0/42 vs 1/116）差异无统计学意义（>0.05）。
ECV能有效降低剖宫产率和非头位分娩率。然而，它需要严格遵守适应证并持续监测。
