超声引导下孕足月外倒转术成功的相关因素分析  

Analysis of the Correlation Factors in External Cephalic Version in the Full Term Under Ultrasound Guidance

作　　者：赵志英[1] 付建红[1] Zhao Zhiying;Fu Jianhong(Department of Obstetrics,The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,450052,China)

机构地区：[1]郑州大学第五附属医院产科,河南郑州450052

出　　处：《黑龙江医学》2025年第8期902-905,共4页Heilongjiang Medical Journal

摘　　要：目的:研究影响超声引导下孕足月外倒转术(ECV)成功的因素。方法:回顾性分析2020年1月—2022年12月在郑州大学第五附属医院产科自愿实施ECV的57名足月单胎臀位或横位孕妇的临床资料,根据ECV是否成功分为成功组(32例)和失败组(25人)。记录两组患者ECV术前的一般资料和ECV术后的妊娠结局,进行单因素分析及logistic回归分析,以筛选出影响ECV实施成功的因素,并比较两组术后妊娠结局差异。结果:两组孕妇的产次、胎盘位置、胎先露类型、脐绕颈情况比较,差异均有统计学意义(χ^(2)=12.498、9.619、7.588、4.776,P<0.05);多因素logistic回归分析结果显示,初产妇、胎盘在前壁、单臀先露均为影响ECV实施成功的不利因素,经产妇、非前壁胎盘、完全臀先露则为有利因素(OR=0.205、0.058、0.218,P<0.05);两组患者分娩方式比较,差异有统计学意义(χ^(2)=40.078,P<0.05);成功组分娩孕周晚于失败组,差异有统计学意义(t=7.531,P<0.05)。结论:ECV可有效降低剖宫产率,但产次、胎盘位置、胎先露类型等均会影响成功率。应在具备急诊条件下,严格把握适应症及禁忌证,充分沟通,结合相关有利因素选择合适人群及时机。Objective:To study the factors affecting the success of external cephalic version(ECV).Methods:This was a restropective analysis of the clinical data of 57 singliton pregnancises in breech or transverse position who accepted ECV in the Fifth Affiliated Hospital of Zhengzhou University from January 2020 to December 2022.All of them were volunteered to undergo the ECV.According to the success of external inversion,they were divided into two groups,including successful and failed groups.Logging the general information before the ECV and pregnancy outcome after the ECV between the two groups.Univariate analysis and logistic regession analysis were performed to screen out the factors the factors affecting the success of external cephalic version.The difference of pregnancy outcome between the two groups was compared.Results:There were significant differences in the number of births,placenta location,type of fetal presentation and umbilical circumferences between the two groups(χ^(2)=12.498,9.619,7.588,4.776;P<0.05).Multivariate logistic regression analysis showed that parturient women and placenta in anterior wall and single hip presentation were all adverse factors affecting the success of ECV implementation,while parturient women,non-anterior wall placenta and complete hip presentation were favorable factors(OR=0.205,0.058,0.218;P<0.05).There was significant difference in delivery mode between the two groups(χ^(2)=40.078,P<0.05).The gestational week of delivery in successful group was later than that in unsuccessful group,and the difference was statistically significant(t=7.531,P<0.05).Conclusion:ECV can effectively reduce the rate of caesarean section,but parity,placental position,fetal presentation and so on can influence the success rate.It is necessary to operate under emergency conditions and full communication,strictly grasp the indications and contraindications,and select the right group and opportunity according to relevant favorable factors.

关 键 词：臀位 外倒转术 相关因素 剖宫产 

分 类 号：R714[医药卫生—妇产科学]