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[从臀位至头位的外倒转术(作者译)]

[External version from breech to vertex presentation (author's transl)].

作者信息

Lehmann V, Rodt C, Criegern T

出版信息

Z Geburtshilfe Perinatol. 1977 Dec;181(6):390-5.

PMID:602329
Abstract

An analysis of 51 attempts at version was made of which 27 were successful (53%). In 3 cases an emergency cesarean section had to be performed following the attempt at version. In 2 of these cases there was partial premature detachment of the placenta. Attempts at version were begun in the 36th week of pregnancy. Up to the 38th week there was a 67% success rate, while from the 39th week onward it was only 41%. In cases of parity it can be shown clearly that the success rate increases with parity. When the pregnancy is the mother's first, 58% of attempts fail, while in fourth pregnancies this figure is only 25%. Attempts at version are most successful when the placenta is attached to the posterior uterine wall. The size and weight of the fetus do not affect success. The average weight of the placenta in the success group is significantly higher (by about 60 g) than in the failure group. There were no significant differences between the two groups as regards the dimensions of the mother's pelvis. In about 30% of cases there was a fetomaternal transfusion. The frequency of erythrocyte transfer is dependent on the force of manipulation used in the attempt at version and on the position of the placenta. The frequency of section is significantly lower (14%) in the success group than in the failure group (43%). Diagnoses of the newborn's condition (pH value and Apgar score) did not reveal any decisive differences between the two groups. In view of the high rate of complications and failures external version from breech to vertex presentation cannot be recommended.

摘要

对51次倒转术尝试进行了分析,其中27次成功(成功率为53%)。在3例尝试倒转术后不得不进行紧急剖宫产。其中2例发生了部分胎盘早剥。倒转术尝试于妊娠第36周开始。至第38周成功率为67%,而从第39周起仅为41%。就产次而言,可以清楚地看出成功率随产次增加。当妊娠为母亲的第一胎时,58%的尝试失败,而在第四胎时这一数字仅为25%。当胎盘附着于子宫后壁时,倒转术最容易成功。胎儿的大小和体重不影响成功率。成功组胎盘的平均重量明显高于失败组(约高60克)。两组母亲骨盆尺寸无显著差异。约30%的病例发生了胎儿 - 母体输血。红细胞转移的频率取决于倒转术尝试中使用的操作力度和胎盘的位置。成功组剖宫产率(14%)明显低于失败组(43%)。对新生儿状况(pH值和阿氏评分)的诊断未显示两组之间有任何决定性差异。鉴于并发症和失败率较高,不建议进行从臀位到头位的外倒转术。

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