What to do when it is breech? A state-of-the-art review on management of breech presentation  

作　　者：Afshin Azimirad 

机构地区：[1]Department of Obstetrics and Gynecology,Tufts Medical Center,Boston,MA 02111,United States [2]Diabetes Clinical Research Center,Massachusetts General Hospital,Harvard Medical School,Boston,MA 02114,United States

出　　处：《World Journal of Obstetrics and Gynecology》2023年第1期1-10,共10页世界妇产科杂志

摘　　要：Any non-cephalic presentation in a fetus is regarded as malpresentation.The most common malpresentation,breech,contributes to 3%-5%of term pregnancies and is a leading indication for cesarean delivery.Identification of risk factors and a proper physical examination are beneficial;however,ultrasound is the gold standard for the diagnosis of malpresentations.External cephalic version(ECV)refers to a procedure aimed to convert a non-cephalic presenting fetus to cephalic presentation.This procedure is performed manually through the mother’s abdomen by a trained health care provider,to reduce the likelihood of a cesarean section.Studies have reported a version success rate of above 50%by ECV.The main objective of this review is to present a broad perspective on fetal malpresentation,ECV,and delivery of a breech fetus.The focus is to elaborate all clinical scenarios of breech and to provide an evidence-based clinical approach for them.After discussing breech prevalence,risk factors,diagnosis,and management,an updated review of ECV is presented.Moreover,ECV indications/contraindications,alternatives,clinical techniques on how to perform ECV and breech vaginal delivery,and obstetrical considerations for the delivery of malpresentations are thoroughly discussed.

关 键 词：Labor presentation Breech presentation Obstetric delivery Cesarean section External cephalic version Fetal version 

分 类 号：TJ3[兵器科学与技术—火炮、自动武器与弹药工程]