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临近足月时在宫缩抑制剂作用下将臀位胎儿外倒转成头先露(作者译)

[External version of fetus from breech to vertex presentation near term under tocolysis (author's transl)].

作者信息

Pluta M, Schmidt S, Giffei J M, Saling E

出版信息

Z Geburtshilfe Perinatol. 1981 Aug;185(4):207-15.

PMID:7199221
Abstract

Between 10th May 1974 and 31st June 1980, 12960 births were registered at the Maternity Hospital, Neukölln; in 508 patients 536 (3,9%) external versions of the fetus from breech to vertex presentation near term were performed under tocolysis; of these 53% were successful. The incidence of births with breech presentation and/or transverse presentation could be reduced from 5.4% to 3.7% after the introduction of external version. Whilst the localization of the placenta did not influence the success to a great extent, the number of successful versions increased with advancing parity. No fetal death was caused by the version in 508 patients (536 attempted versions). In 11 attempted versions complications occurred in the form of early partial separation of the placenta and/or umbilical cord presentation. Experience and a more circumspect approach led to a definite decrease in the number of complications. As a result of our findings - and bearing in mind the contraindications and observance of safety measures - the external version can be recommended as a simple method of reducing the risk to infant and mother in the treatment of breech presentations.

摘要

1974年5月10日至1980年6月31日期间,新克尔恩妇产医院登记了12960例分娩;在508例患者中,于宫缩抑制剂作用下对536例(3.9%)近足月胎儿进行了外倒转术,将臀位转为头位;其中53%成功。引入外倒转术后,臀位和/或横位分娩的发生率可从5.4%降至3.7%。虽然胎盘的位置在很大程度上不影响成功率,但成功倒转的次数随着产次增加而增多。508例患者(尝试进行536次倒转术)中无因倒转术导致胎儿死亡的情况。在11次尝试的倒转术中,出现了胎盘早期部分剥离和/或脐带脱垂形式的并发症。经验积累和更谨慎的操作使并发症数量明显减少。基于我们的研究结果,并考虑到禁忌症和安全措施的遵守情况,外倒转术可作为一种降低臀位分娩时母婴风险的简单方法予以推荐。

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