单胎臀位外倒转术的影响因素分析

doi:10.3877/cma.j.issn.2095-3259.2016.02.010

中华产科急救电子杂志 ›› 2016, Vol. 05 ›› Issue (02) : 110 -113. doi: 10.3877/cma.j.issn.2095-3259.2016.02.010

所属专题：文献；

论著

单胎臀位外倒转术的影响因素分析

王晓怡¹, 黄赟博¹, 林琳¹, 陈敦金¹^,^†(

)

^1. 510150　广州医科大学附属第三医院妇产科　广州重症孕产妇救治中心

收稿日期:2016-03-06 出版日期:2016-05-18
通信作者: 陈敦金

Analyzing influencing factors of external cephalic version for breech presentation in singleton pregnancies

Xiaoyi Wang¹, Yunbo Huang¹, Lin Lin¹, Dunjin Chen¹^,^†()

^1. Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China

Received:2016-03-06 Published:2016-05-18
Corresponding author: Dunjin Chen
About author:
Corresponding author: Chen Dunjin, Email: gzdrchen@gzhmu.edu.cn

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目的

探讨影响单胎臀位外倒转术成功率的相关因素。

方法

对2015年11月至2016年4月就诊于广州医科大学附属第三医院妇产科进行外倒转术的20例单胎孕妇的临床资料进行回顾性分析，患者均为单胎妊娠，孕龄在35～38周之间，不合并绝对剖宫产指征，均愿接受行外倒转术。分析影响外倒转术成功率的相关因素，统计学采用χ²检验。

结果

20例外倒转术有14例(70%)完成倒转，其中12例(60%)倒转成功并经阴道分娩。比较单臀位和复合臀位[7/9例与7/11例]，初产妇及经产妇[5/8例与9/12例]、胎盘位于前壁、后壁和宫底[5/8例，6/8例与3/4例]、妊娠足月与否[4/6例与10/14例]、羊水量正常与否[12/17例与2/3例]、脐带绕颈与否[2/4例与12/16例]的外倒转成功率，差异无统计学意义(P>0.05)。胎儿窘迫、胎盘早剥和早产的发生率分别为10.0%(2/20)例、5.0%(1/20)例和2/14例。

结论

外倒转术能较为安全有效将臀位转为头位，适用于足月或近足月妊娠，可达到降低剖宫产率的目的。

关键词: 臀位, 外倒转术, 并发症

Objective

To analyze the influencing factors of external cephalic version (ECV) for breech presentation in singleton pregnancies.

Methods

Twenty pregnant women were single pregnancy with breech presentation during 35-38 weeks of gestation. They were without other indications for cesarean section and volunteered to undergo ECV, who were admitted in the Third Affiliated Hospital of Guangzhou Medical University from November 2015 to April 2016. The clinical data of 20 pregnant women were retrospectively analyzed. The factors influencing the success rate of ECV were analyzed by χ² tests.

Results

The success rate of ECV was 70% (14/20), and 12 cases (60%) underwent vaginal delivery at the end. There was no significant difference in the success rates between frank breech presentation and complete breech presentation (seven ninths vs. seven elevenths). Compared with primiparas and multiparas (five eighths vs. nine twelfths), it was not significant different. Compared in placenta position, deliver time, amniotic fluid volume and umbilical cord condition, there were not different. The incidences of fetal distress, placental abruption and premature delivery were 10.0%(2/20 cases), 5.0%(1/20 cases) and 14.3%(2/14 cases), separately.

Conclusion

To reduce the cesarean section rate, ECV for signal pregnancy with breech presentation in full-term and nearly full-term can effectively adjust the fetal position.

Key words: Breech presentation, External cephalic version, Complication

表1 不同因素对外倒转术成功的影响

影响因素		总例数	成功例数	成功率(%)	χ²值	P值
臀位类型		?	?	?	?	?
?	单臀位	9	7	7/9^a	0.038	0.642
?	复合臀位	11	7	7/11^a	?	?
产次		?	?	?	?	?
?	初产妇	8	5	5/8^a	0.010	0.642
?	经产妇	12	9	9/12^a	?	?
胎盘位置		?	?	?	?	?
?	前壁	8	5	5/8^a	0.357	0.836
?	后壁	8	6	6/8^a	?	?
?	宫底	4	3	3/4^a	?	?
实施外倒转术的孕周		?	?	?	?	?
?	足月	6	4	4/6^a	0.000	1.000
?	未足月	14	10	10/14^a	?	?
羊水量		?	?	?	?	?
?	正常	17	12	21/17^a	0.000	1.000
?	过少	3	2	2/3^a	?	?
脐带绕颈		?	?	?	?	?
?	是	4	2	2/4^a	0.134	0.549
?	否	16	12	12/16^a	?	?

表1 不同因素对外倒转术成功的影响

影响因素		总例数	成功例数	成功率(%)	χ²值	P值
臀位类型		?	?	?	?	?
?	单臀位	9	7	7/9^a	0.038	0.642
?	复合臀位	11	7	7/11^a	?	?
产次		?	?	?	?	?
?	初产妇	8	5	5/8^a	0.010	0.642
?	经产妇	12	9	9/12^a	?	?
胎盘位置		?	?	?	?	?
?	前壁	8	5	5/8^a	0.357	0.836
?	后壁	8	6	6/8^a	?	?
?	宫底	4	3	3/4^a	?	?
实施外倒转术的孕周		?	?	?	?	?
?	足月	6	4	4/6^a	0.000	1.000
?	未足月	14	10	10/14^a	?	?
羊水量		?	?	?	?	?
?	正常	17	12	21/17^a	0.000	1.000
?	过少	3	2	2/3^a	?	?
脐带绕颈		?	?	?	?	?
?	是	4	2	2/4^a	0.134	0.549
?	否	16	12	12/16^a	?	?

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Analyzing influencing factors of external cephalic version for breech presentation in singleton pregnancies

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Analyzing influencing factors of external cephalic version for breech presentation in singleton pregnancies