足月妊娠外倒转术成功的影响因素及成功后经阴道分娩的影响因素探讨  

Exploration of the influencing factors of successful external cephalic version at term and postoperative vaginal delivery

作　　者：朱亚农 曹宁宁 范燕春 ZHU Ya-nong;CAO Ning-ning;FAN Yan-chun(Delivery Room,Liaocheng Dongchangfu District Maternal and Child Health Hospital,Liaocheng 252000,China)

机构地区：[1]聊城市东昌府区妇幼保健分娩室,252000 [2]聊城市东昌府区妇幼保健围产医学科,252000

出　　处：《中国现代药物应用》2025年第3期44-47,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探究足月妊娠外倒转术(ECV)成功的影响因素及术后阴道分娩的影响因素。方法回顾性分析110例实施ECV治疗的足月妊娠孕妇临床资料,按照治疗结局是否成功分为成功组(n=44)以及失败组(n=66),采取单因素以及多因素Logistic回归分析探讨ECV成功的影响因素。将ECV成功的孕妇按照分娩方式的不同分为经阴道分娩组(n=31)以及剖宫产组(n=13),采取单因素以及多因素Logistic回归分析探讨ECV成功后经阴道分娩的影响因素。结果与失败组(34.85%、42.42%、40.91%)相比,成功组能够触及胎头、存在前羊水囊占比较高,使用前后联合翻滚手法占比较低(61.36%、72.73%、20.45%),差异有统计学意义(P<0.05);成功组与失败组年龄、孕周、体重、胎儿体重、胎位稳定占比、胎心监测正常占比比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,不能够触及胎头、不存在前羊水囊为影响ECV成功的高危因素,未使用前后联合翻滚手法为影响ECV成功的保护因素(P<0.05)。与剖宫产组的(3.95±1.85)d相比,经阴道分娩组ECV至分娩间隔天数(5.35±2.12)d较长,差异有统计学意义(P<0.05);经阴道分娩组与剖宫产组年龄、孕周、体重及新生儿体重比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,对于ECV成功的孕妇,ECV至分娩间隔天数短为经阴道分娩的高危因素(P<0.05)。结论不能够触及胎头、不存在前羊水囊是影响足月妊娠ECV成功的高危因素,未使用前后联合翻滚手法为保护因素;对于ECV成功的孕妇,ECV至分娩间隔天数短为经阴道分娩的高危因素。Objective To explore the influencing factors of successful external cephalic version(ECV)at term and postoperative vaginal delivery.Method Clinical data of 110 pregnant women who underwent ECV at term were retrospectively analyzed,and they were divided into successful group(n=44)and failure group(n=66)based on whether the treatment outcome was successful.Univariate and multivariate Logistic regression analysis was used to explore the influencing factors of successful ECV.Pregnant women with successful ECV were divided into vaginal delivery group(n=31)and cesarean section group(n=13)according to different delivery methods.Univariate and multivariate Logistic regression analysis was used to explore the influencing factors of vaginal delivery after successful ECV.Results Compared with the failure group(34.85%,42.42%,40.91%),the success group had higher percentages of palpable fetal head and anterior amniotic sac present and low percentage of combination of forward roll and backflip(61.36%,72.73%,20.45%),and the difference was statistically significant(P<0.05).There was no statistically significant difference in comparison of age,gestational week,weight,fetal weight,proportion of stable fetal position,and proportion of normal fetal heart monitoring between the successful group and failure group(P>0.05).Multivariate Logistic regression analysis showed that failure of palpable fetal head and absence of anterior amniotic sac were high risk factors for successful ECV at term,and the absence of combination of forward roll and backflip was a protective factor(P<0.05).Compared with(3.95±1.85)d in the cesarean section group,the interval from ECV to delivery was longer in the vaginal delivery group at(5.35±2.12)d,and the difference was statistically significant(P<0.05).There was no significant difference in comparison of age,gestational weeks,weight and neonatal weight between the vaginal delivery group and the cesarean section group(P>0.05).Multivariate Logistic regression analysis showed that for pregnant women with succe

关 键 词：足月妊娠外倒转术 经阴道分娩 剖宫产 高危因素 

分 类 号：R714.3[医药卫生—妇产科学]