单胎臀位妊娠行外转胎位术的影响因素及妊娠结局分析

Influencing factors and pregnancy outcomes of external cephalic version for breech presentation in singleton pregnancies

目的分析单胎臀位行外转胎位术的影响因素及妊娠结局。方法收集产检单胎臀位妊娠的102例患者临床资料,比较胎头外倒转成功者(成功组)与胎头外倒转失败者(失败组)产妇的年龄、外倒转孕周、孕前BMI、孕期BMI增加、产次、羊水深度、胎盘位置、脐带绕颈等危险因素,以及外转胎位术后妊娠结局(包括分娩的间隔、孕周、方式和新生儿pH值、黄疸、转儿科ICU、早产等差异。结果 102例中,成功63例(61.8%),失败39例(38.2%),成功组与失败组患者的年龄、实施外转胎位术的孕周、孕前BMI、孕期BMI增加、产次、羊水深度、胎盘位置、脐带绕颈及新生儿体质量比较差异均无统计学意义(P均>0.05)。与失败组比较,成功组患者的分娩间隔和分娩孕周均较长、阴道顺产率较高(P均<0.05)。2组新生儿的pH值、黄疸和转科率比较差异均无统计学意义(P均>0.05)。结论对单胎臀位妊娠实施外转胎位术,可增加阴道顺产率,降低剖宫产率。

Objective To analyze influencing factors and pregnancy outcomes of external cephalic version(ECV)for breech presentation in singleton pregnancies.Methods Clinical data of102cases of singleton pregnancy with breech presentation were retrospectively analyzed.All participants were divided into the success and failure groups.Risk factors including age,gestational week of ECV,BMI before and during pregnancy,times of delivery,amniotic fluid depth,placental position and umbilical cord around neck were analyzed.The pregnancy outcomes including delivery interval,gestational week,delivery pattern,neonatal pH,jaundice,transfer to pediatric ICU and premature delivery were statistically compared between two groups.Results Among102cases,ECV was successfully performed in63(61.8%)and failed in39(38.2%).Age,gestational week of ECV,BMI before and during pregnancy,times of delivery,amniotic fluid depth,placental position,umbilical cord around neck and birth weight did not significantly differ between two groups(allP>0.05).The delivery interval and delivery week were significantly longer and the vaginal delivery rate was considerably higher in the success group compared with those in the failure group(allP<0.05).No statistical significance was observed in the neonatal pH,jaundice and transfer to pediatric ICU between two groups(allP>0.05).Conclusion To reduce the cesarean section rate and increase the vaginal delivery rate,ECV is recommended for breech presentation in singleton pregnancies.