Healey M, Porter R, Galimberti A
Department of Obstetrics and Gynaecology, Royal United Hospital, Bath.
Br J Obstet Gynaecol. 1997 Sep;104(9):1073-9. doi: 10.1111/j.1471-0528.1997.tb12070.x.
To audit the effect of introducing external cephalic version at > or = 36 weeks on breech delivery rates and modes, and to assess factors that affect external cephalic version success rates.
A prospective unblinded study over 12 months of factors affecting external cephalic version success. A retrospective review of breech deliveries for 12 months before introducing external cephalic version and the first 12 months of practising external cephalic versions.
Royal United Hospital, Bath.
One hundred and three women (> or = 36 weeks) with breech presentation booked for external cephalic version, and 324 women with a singleton breech presentation at delivery between November 1992 and October 1994.
External cephalic version attempted on 89 women. Tocolysis was used on 41 of these women.
External cephalic version success rate. Breech presentation rates (suitable for external cephalic version) at delivery. Delivery mode rates for breeches.
External cephalic version was successful in 39% of women. The breech presentation rate (external cephalic version suitable) at delivery fell from 2.7% to 2.4% of all deliveries. The vaginal breech delivery rate fell from 0.98% to 0.51%. The caesarean section rate was 63% for breeches (external cephalic version suitable) before external cephalic version introduction, and 47% among women who had an attempted external cephalic version.
Attempted external cephalic version reduces the woman's risk of vaginal breech delivery and caesarean section. It provides individual women with a third management option and the possibility of avoiding a vaginal breech delivery or a caesarean section. To avoid one caesarean section takes 5.9 attempted external cephalic versions. This approach is expensive in operator time. Operator, placental site, position of fetal back and amniotic fluid index had a significant effect on the success of external cephalic version.
审核在孕36周及以上时实施外倒转术对臀位分娩率及分娩方式的影响，并评估影响外倒转术成功率的因素。
一项为期12个月的关于影响外倒转术成功因素的前瞻性非盲研究。对实施外倒转术前12个月的臀位分娩情况以及实施外倒转术的前12个月情况进行回顾性分析。
巴斯皇家联合医院。
103名孕36周及以上、臀位且预约接受外倒转术的女性，以及1992年11月至1994年10月期间分娩时为单胎臀位的324名女性。
对89名女性尝试进行外倒转术。其中41名女性使用了宫缩抑制剂。
外倒转术成功率。分娩时臀位发生率（适合外倒转术）。臀位分娩方式发生率。
39%的女性外倒转术成功。分娩时臀位发生率（适合外倒转术）在所有分娩中从2.7%降至2.4%。阴道臀位分娩率从0.98%降至0.51%。在引入外倒转术之前，适合外倒转术的臀位剖宫产率为63%，尝试外倒转术的女性中该比例为47%。
尝试外倒转术可降低女性阴道臀位分娩和剖宫产的风险。它为个体女性提供了第三种管理选择以及避免阴道臀位分娩或剖宫产的可能性。要避免一次剖宫产需要进行5.9次外倒转术尝试。这种方法在术者时间方面成本较高。术者、胎盘位置、胎儿背部位置及羊水指数对外倒转术的成功有显著影响。
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