B超联合静滴硫酸特布他林应用于臀位外倒转术的效果

Effect of B-ultrasound combined with intravenous terbutaline sulfate for external cephalic version

目的:探讨采取B超联合静滴硫酸特布他林应用于臀位外倒转术的效果及对母儿并发症的影响。方法:选取2014年1月至2016年6月在产检的B超确诊为臀位的孕34~36周的单胎孕妇126例,按随机数字表的方法分为观察组70例,对照组56例。观察组术前行硬膜外麻醉后静滴硫酸特布他林,在B超监护下行外倒转术。对照组行传统的膝胸卧位纠正胎位。记录并比较两组胎位纠正成功率、臀位复转率、剖宫产率、阴道分娩率、不良反应、产后出血、新生儿窒息及新生儿产伤。结果:与对照组比较,观察组胎位纠正成功率和阴道分娩率增高,剖宫产率降低,差异有统计学意义(c2=20.210、8.564,P<0.05);两组产后出血、新生儿窒息及新生儿产伤发生率比较,差异无统计学意义(P>0.05)。结论:采取B超联合静滴硫酸特布他林应用于臀位外倒转术,成功率高,操作难度小,安全性高,可以显著降低剖宫产率,有效提高阴道分娩成功率。

Objective To investigate the effect of ultrasound combined with intravenous terbutaline sulfate for external cephalic version and the impact of this therapy on maternal and neonatal complications. Methods 126 singleton pregnant women who were diagnosed by B-ultrasound breech pregnancy at 34-36 weeks in regular antenatal examination from January 2014 to June 2016 were randomly divided into an observation group （n = 70） and a control group （n = 50）. The observation group was treated with intravenous drip of terbutaline sulfate after epidural anesthesia, and then received external cephalic version under B-ultrasound monitoring. The control group received traditional knee-chest position for correcting breech presentation. The success rate of breech correction, breech version rate, cesarean section rate, vaginal delivery rate, adverse reactions, postpartum hemorrhage volume, neonatal asphyxia, and neonatal birth injury were noted and compared between the two groups. Results As compared with the control group, the observation group had a higher success rate of breech correction and a higher rate of vaginal delivery while a lower rate of cesarean section, with a significant difference （χ2 = 20.210, 8.564; P 〈 0.05）. The rate of postpartum hemorrhage, neonatal asphyxia, or neonatal birth injury did not differ significantly between the two groups （P 〉 0.05）. Conclusions Application of ultrasound combined with intravenous terbutaline sulfate in external cephalic version is easy to operate and has a higher success rate and greater safety, significantly reducing the rate of cesarean section and improve the success rate of vaginal delivery.