Schachter M, Kogan S, Blickstein I
Department of Obstetrics and Gynecology, Kaplan Hospital, Rehovot, Israel.
Int J Gynaecol Obstet. 1994 Apr;45(1):17-20. doi: 10.1016/0020-7292(94)90760-9.
To describe our limited experience with external cephalic version from breech to vertex presentation at term, with the use of ritodrine tocolysis, in women who had undergone a previous cesarean delivery.
Eleven parturients after previous cesarean delivery underwent external version after 36 gestational weeks, utilizing tocolysis with ritodrine, after excluding cases of low-lying placenta, severe oligohydramnion or ruptured membranes. Patients were then followed until delivery and scar examination was carried out after vaginal delivery, or at re-cesarean section, according to mode of delivery.
All 11 attempted versions were successful. Six patients subsequently delivered vaginally and five by re-cesarean section. None of the uterine scars showed any signs of dehiscence. Three of the five infants delivered by re-cesarean section weighed over 4000 g, whereas all of the vaginally-delivered infants weighed under 3500 g.
External cephalic version to vertex presentation after previous cesarean section was successful in all 11 carefully selected patients. No untoward effects were noted, and no signs of scar dehiscence were found. The safety and efficacy of this procedure after previous cesarean delivery should be examined further.
描述我们在足月时对曾行剖宫产的孕妇使用利托君抑制宫缩进行外倒转术，将臀位转为头位的有限经验。
11例曾行剖宫产的产妇在妊娠36周后，在排除前置胎盘、严重羊水过少或胎膜破裂的病例后，使用利托君抑制宫缩进行外倒转术。然后对患者进行随访直至分娩，并根据分娩方式在阴道分娩后或再次剖宫产时进行瘢痕检查。
所有11例尝试的外倒转术均成功。6例患者随后经阴道分娩，5例再次剖宫产。子宫瘢痕均未显示任何裂开迹象。5例经再次剖宫产分娩的婴儿中有3例体重超过4000克，而所有经阴道分娩的婴儿体重均低于3500克。
在11例精心挑选的曾行剖宫产的患者中，外倒转术转为头位均成功。未观察到不良影响，也未发现瘢痕裂开迹象。既往剖宫产术后该手术的安全性和有效性应进一步研究。
