分析臀位外倒转术的妊娠结局及与成功率相关的影响因素

目的 探讨臀位外倒转术(ECV)的临床应用价值,分析与ECV成功率相关的影响因素.方法 回顾性收集2019年2月至2020年7月在安徽省妇幼保健院定期产检并在本院产科分娩的胎儿臀位孕妇资料123例,其中实施ECV 40例,计划剖宫产83例.实施ECV的孕妇中,成功转为头位经阴道分娩23例(ECV成功组),失败17例(E...

Analysis onpregnancy outcome of external cephalic version for term breech presentation and its influencing factors affecting success

Objective To discuss the clinical value of external cephalic version (ECV) for term breech presentation with an analysis on its success factors. Methods A total of 123 cases of pregnant women with breech presentation who underwent regular prenatal examinations and delivered in Anhui Province Maternity and Child Health Hospital from February 2019 to July 2020 were retrospectively selected, including 43 cases who underwent external cephalic and 80 cases who underwent planned cesarean section. Among the ECV group, 23 cases were successfully transferred to vaginal delivery of the head position (ECV success group), and 17 cases failed (ECV failure group). The pregnancy outcome and the relevant success influencing factors were compared and analyzed between ECV success group, ECV failure group and the planned cesarean section group. Results In comparison among the three groups, there were statistical significance (P<0.05) in terms of parturition number and gestational weeks of delivery. But there was no significant difference in maternal age, maternal BMI and birth weight of newborns (P>0.05). And there was no statistical significance (P>0.05) for the factors in terms of hysterectomy, neonatal birth injury, amniotic fluid turbidity, neonatal mortality, neonatal asphyxiation and Apgar score among the three groups. There was no statistical significance (P>0.05) in terms of such factors as maternal age, parturition number, gestational age, estimation of fetal weight, maternal body mass index, breech position, umbilical cord length, cord around neck or not, or amniotic fluid index between ECV success group and ECV failure group. There were statistical significance (P<0.05) in terms of type of breech, fetal position and the thickness of subcutaneous fat in pregnant women between the two groups (P<0.05). Non-posterior placenta and thicker subcutaneous fat were risk factors for failure of external inversion according a multivariate analysis. Conclusions ECV is safe to be performed. Non-posterior placenta and thicker subcutaneous fat in pregnant women are the risk factors for success.