成功的臀位外倒转术对分娩方式及母儿结局的影响  

The Effect of Successful External Cephalic Version for Breech Presentationon Mode of Delivery and Perinatal Outcomes

作　　者：谭章敏 张培珍[1] 程林 尹玉竹[1] TAN Zhangmin;ZHANG Peizhen;CHENG Lin(Department of Obstetrics and Gynecology,the Third Affiliated Hospital,SunYat-sen University,Guangzhou Guangdong 510630,China;Department of Thyroid and Breast Surgery,the Third Affiliated Hospital,SunYat-sen University,Guangzhou Guangdong 510630,China)

机构地区：[1]中山大学附属第三医院产科,广东广州510630 [2]中山大学附属第三医院甲状腺乳腺外科,广东广州510630

出　　处：《实用妇产科杂志》2019年第8期625-629,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨妊娠晚期成功的臀位外倒转术对分娩方式及母儿结局的影响。方法:选择2016年1月至2018年5月在中山大学附属第三医院产前检查并分娩的产妇452例,其中妊娠晚期胎位臀位且自愿选择行外倒转术的产妇134例,外倒转术成功且至分娩时胎位仍为头位的80例产妇为外倒转术组,另选择同期胎位头位选择阴道分娩的318例产妇作为对照组,进行随访观察,比较两组产妇的分娩方式及母儿结局。结果:外倒转术组产妇的剖宫产率(15.00%)和紧急剖宫产率(12.50%)明显高于对照组的剖宫产率(5.35%)和紧急剖宫产率(4.72%),差异均有统计学意义(P<0.05)。两组产妇的引产率、阴道助产率、羊水浑浊率及产后出血情况比较,差异均无统计学意义(P>0.05)。两组新生儿死亡率、新生儿窒息率、Apgar1分钟评分、Apgar5分钟评分、脐动脉血PH值及碱剩余比较,差异均无统计学意义(P>0.05)。结论:经臀位外倒转术成功后的产妇虽剖宫产率较普通头位产妇略有升高,但其他方面对产妇和新生儿无明显影响,臀位外倒转术仍为改变胎位、提高阴道分娩率的重要手段。Objective:To determine the effect of successful external cephalic version for breech presentation in third trimester on themode of delivery and perinatal outcomes .Methods:The clinical information of 452 pregnant women who received antenatal careand delivered from January 2016 to May 2018 at the Third Affiliated Hospital of Sun Yat-Sen University were reviewed retrospectively.Total 134 pregnant women were treated with external cephalic version for breech presentation,in which 80 pregnant women with cephalic presentation before delivery were selected as the experimental group.Another 318 women with cephalic presentation who underwent spontaneous vaginal delivery were selected as the control group.The mode of delivery and perinatal outcomes were compared between both groups.Results:The caesarean delivery rate in the experimental group was 15.00%.The emergency cesarean delivery rate was 12.50%.Both were obviously higher than those in the control group 5.35% and 4.72%,respectively(P<0.05).However,no significant differences were observed between two groups as for the induction of labor rate,the instrumental delivery rate,the amniotic fluid turbidity rate and postpartum hemorrhage(P>0.05). No significant differences were shown in neonatal mortality,neonatalasphyxia,Apgar score(at the first and fifth minute),umbilical artery pHandbase excess(BE)(P>0.05).Conclusions:Although,the rate of caesarean section could increase in cephalic presenting pregnancies following successful external cephalic version compared with spontaneous cephalic presentation pregnancies,no other influences were shown on parturients and neonates. External cephalic version was still an important means for changing the position of the fetus and increasing the rate of vaginal delivery.

关 键 词：妊娠晚期 臀位 外倒转术 分娩方式 母儿结局 

分 类 号：R714.44[医药卫生—妇产科学]