臀位外倒转手术效果影响因素分析

Analysis of the factors influencing the effect of external cephalic version

目的探讨影响足月臀位外倒转手术成功相关因素。方法回顾性分析2017年8月至2019年9月于郑州大学附属郑州中心医院实施臀位外倒转术的126例孕晚期单胎孕妇的临床资料,按外倒转手术结果分为成功组(n=75)和失败组(n=51),分析影响外倒转手术结果的相关因素,并比较2组孕妇分娩方式和并发症发生情况。结果126例患者中,外倒转手术成功75例,总体成功率为59.5%(75/126),失败51例,总体失败率为40.4%(51/126);其中初产妇成功率为46.3%(31/67),经产妇成功率为74.5%(44/59)。2组孕妇的年龄、操作孕周、体质量指数、胎盘位置比较差异无统计学意义(P>0.05);2组孕妇的产次、羊水指数、胎先露类型比较差异有统计学意义(P<0.05)。75例外倒转成功孕妇中,73例自然分娩,2例后续行剖宫产;51例外倒转失败孕妇均行剖宫产。成功组1例发生新生儿窒息,2组均无胎膜早破发生。结论单胎臀位孕妇足月后行外倒转可以提高自然分娩成功率,术前应充分评估孕妇情况,重点关注产次、羊水指数、胎先露类型等因素。

Objective To investigate the factors influencing the results of external cephalic version(ECV)of full-term breech position gravida.Methods The clinical data of 126 full-term breech position pregnant women who received ECV in Zhengzhou Central Hospital Affiliated to Zhengzhou University from August 2017 to September 2019 were analyzed retrospectively.They were divided into success group(n=75)and failure group(n=51)according to the results of ECV.The related factors influencing the results of ECV were analyzed.The delivery mode and complications were compared between the two groups.Results Among the 126 pregnant women,75 were successful after the operation,the overall success rate was 59.5%(75/126),51 were failed and the overall failure rate was 40.4%(51/126).The success rate of primipara was 46.3%(31/67),and the success rate of multipara was 74.5%(44/59).There was no significant difference in the age,gestational age,body mass index and placental position between the two groups(P>0.05);while there was significant difference in the parity,amniotic fluid index and fetal presentation type between the two groups(P<0.05).In the success group,73 pregnant women were spontaneous delivery,2 pregnant women were uterine-incision delivery;in the failure group,all pregnant women were given uterine-incision delivery.One case of neonatal asphyxia occurred in the success group,and there was no premature rupture of membrane in the two groups.Conclusions The success rate of natural delivery can be improved by ECV in full-term breech position pregnancy women.The conditions of pregnancy women should be fully evaluated before operation and the evaluation should focus on parity,amniotic fluid index and fetal presentation type,etc.