Coco A S, Silverman S D
Lancaster General Hospital, Pennsylvania, USA.
Am Fam Physician. 1998 Sep 1;58(3):731-8, 742-4.
External cephalic version is a procedure that externally rotates the fetus from a breech presentation to a vertex presentation. External version has made a resurgence in the past 15 years because of a strong safety record and a success rate of about 65 percent. Before the resurgence of the use of external version, the only choices for breech delivery were cesarean section or a trial of labor. It is preferable to wait until term (37 weeks of gestation) before external version is attempted because of an increased success rate and avoidance of preterm delivery if complications arise. After the fetal head is gently disengaged, the fetus is manipulated by a forward roll or back flip. If unsuccessful, the version can be reattempted at a later time. The procedure should only be performed in a facility equipped for emergency cesarean section. The use of external cephalic version can produce considerable cost savings in the management of the breech fetus at term. It is a skill easily acquired by family physicians and should be a routine part of obstetric practice.
外倒转术是一种将胎儿从臀位转为头位的外部操作方法。由于良好的安全记录和大约65%的成功率，外倒转术在过去15年中再度兴起。在外倒转术重新应用之前，臀位分娩的唯一选择是剖宫产或试产。由于成功率较高且如果出现并发症可避免早产，最好等到足月（妊娠37周）再尝试外倒转术。在胎儿头部轻轻松解后，通过向前滚动或向后翻转来操作胎儿。如果不成功，可在稍后时间再次尝试。该操作应仅在配备急诊剖宫产设备的机构进行。外倒转术在足月臀位胎儿的管理中可节省大量费用。这是家庭医生容易掌握的一项技能，应成为产科实践的常规部分。
