Cook H A
Department of Obstetrics and Gynecology, Saint Joseph's Hospital, Bellingham, Washington.
Am J Obstet Gynecol. 1993 Jun;168(6 Pt 1):1886-9; discussion 1889-90. doi: 10.1016/0002-9378(93)90707-p.
The purpose of this study was to decrease the rate of cesarean delivery for breech presentation through use of a protocol that calls for external cephalic version and selected vaginal delivery of the infant in breech position.
I offered external cephalic version to patients whose fetuses were in the breech position beyond 36 weeks' gestation and who were not in active labor. Patients in active labor were included in the review if they agreed to a trial of labor.
Sixty-five deliveries were included in this review. The success rate of the version procedure was 53%. Among patients in whom version was successful 28% required cesarean delivery. Of those remaining breech fetuses believed to be candidates for vaginal delivery, 80% were successfully delivered vaginally. The overall vaginal delivery rate was 31 of 65 deliveries, or 48%.
Protocols that call for external cephalic version with vaginal delivery of selected fetuses in breech presentation that either do not respond to or are not candidates for version can be used in the private practice setting. Such protocols should result in a decreased number of cesarean sections.
本研究的目的是通过采用一种方案来降低臀位剖宫产率，该方案要求进行外倒转术并对部分臀位胎儿选择经阴道分娩。
我为妊娠36周后胎儿为臀位且未临产的患者提供外倒转术。如果临产患者同意试产，则将其纳入研究。
本研究纳入了65例分娩病例。外倒转术的成功率为53%。在外倒转术成功的患者中，28%需要剖宫产。在其余被认为适合经阴道分娩的臀位胎儿中，80%经阴道成功分娩。总的经阴道分娩率为65例分娩中有31例，即48%。
要求对不适合或不接受外倒转术的部分臀位胎儿进行外倒转术并经阴道分娩的方案可用于私人执业环境。此类方案应能减少剖宫产的数量。
