Prevalence, Maternal and Perinatal Prognosis of Breech Delivery Compared to That of the Vertex in 242 Cases for 484 Controls at Ségou Hospital in Malti

Introduction: Breech birth has always been a subject of great interest because of its risks of perinatal morbidity and mortality. Aim: The aim of our study was to compare the maternal and perinatal prognosis of breech delivery with that of vertex delivery. Patients and Method: This was a retrospective case-control analytical study carried out in the obstetrics and gynaecology department of Ségou hospital over a 2-year period from 1 January 2020 to 31 December 2021, involving 242 breech deliveries compared with 484 top deliveries with a live single foetus without foetal malformation of gestational age ≥ 35 SA. The statistical tests used were: chi² (p Results: The frequency of breech delivery was 3.3%, with a predominance of caesarean section for breech presentation (64.88%) compared with 32.85% for vertex (P: 0.00;CI: (0.191 - 0.367). The perinatal prognosis of fetuses with breech presentations was marked by a higher rate of neonatal asphyxia (Apgar score Conclusion: Breech birth is relatively rare in our department. It carries a higher risk of maternal morbidity and neonatal morbidity than breech delivery. However, the vital prognosis for the mother was identical in both groups.

What to do when it is breech? A state-of-the-art review on management of breech presentation

Any non-cephalic presentation in a fetus is regarded as malpresentation.The most common malpresentation,breech,contributes to 3%-5%of term pregnancies and is a leading indication for cesarean delivery.Identification of risk factors and a proper physical examination are beneficial;however,ultrasound is the gold standard for the diagnosis of malpresentations.External cephalic version(ECV)refers to a procedure aimed to convert a non-cephalic presenting fetus to cephalic presentation.This procedure is performed manually through the mother’s abdomen by a trained health care provider,to reduce the likelihood of a cesarean section.Studies have reported a version success rate of above 50%by ECV.The main objective of this review is to present a broad perspective on fetal malpresentation,ECV,and delivery of a breech fetus.The focus is to elaborate all clinical scenarios of breech and to provide an evidence-based clinical approach for them.After discussing breech prevalence,risk factors,diagnosis,and management,an updated review of ECV is presented.Moreover,ECV indications/contraindications,alternatives,clinical techniques on how to perform ECV and breech vaginal delivery,and obstetrical considerations for the delivery of malpresentations are thoroughly discussed.

Pull Breech out versus Push Impacted Head up in Emergency Cesarean Section: A Comparative Study

Objective: To compare maternal and fetal outcome associated with two methods Reverse breech extraction versus Head pushing to deliver the impacted fetal head in advanced labor requiring emergency Cesarean section. Method: A prospective comparative study was conducted on 80 pregnant women at term with cephalic presentation in advanced labour, requiring emergency Cesarean Section. Reverse breech extraction technique (pull method) was used in 40 cases (group I) and pushing the head up through the vagina (“push” method) was tried in (group II) 40 cases. The maternal outcome was assessed by extension of the uterine Incision, bladder injury, intra and postoperative blood transfusion, Postpartum hemorrhage, wound infection and duration of hospital stay. Fetal outcome was Apgar score and admission to neonatal intensive care unit. Results: Extension of the uterine incision was significantly lower in women undergoing reverse breech extraction compared to cephalic delivery (20% versus 50%;p = 0.001). The mean operative time (pull group) was lower than that in the (push group) 59.7 ± 4.2, versus 75.2 ± 6.1 p = 0.001 and blood loss was significantly lower in the (pull group) than that in the (push group) 878 ± 67 ml, versus 1321 ± 57 ml, p = 0.001. No significant difference between groups regarding maternal and neonatal outcome. Conclusion: Reverse breech extraction (pull) is safer than pushing head up through vagina (push) for delivery of a deeply impacted fetal head in advanced labour sensitizing emergency Cesarean Section and is associated with the least maternal complications.

Report of a New Case of Interlocking Heads in a Breech-Vertex Twin Delivery: A Conversation with My Residents

“Locked twins” is a rare event occurring in about 1 in every 1000 twin births. A 21-year-old primigravida with a 31-week twin pregnancy was admitted for delivery. The head of the first twin was locked to the chin of the second twin at the top of the symphysis pubis. Caesarean section was performed allowing the delivery of both dead twins. Twins gestations with first twin in the breech presentation raise index of suspicion of potential locked twin. However, management of such situation is controversial with most authors and colleges recommending caesarean section to avoid interlocking heads. We report another rare case of interlocking heads and bring up the topic about management of breech-first twin deliveries.

Breeches, Sword Play and Intriguing Ladies: Performing the Spanish Code of Honor as a Model for Social Formation in the Plays of the English Restoration

Over 10%of English Restoration drama engaged its audience through plays that were translated from or imitated the Spanish capa y espada form of theatre.English plays modeled on this form used Spanish locations and a constructed and rigid idea of honor as a proxy for English society.While dialogue was still important,it performed physical action of this form,including frequent use of breeches roles and female characters sword fighting,allowed for different and effective critiques and models of social behavior for women in England.Particularly important were concerns about women’s behavior and status in English society,and the presence of the actress for the first time on English stages heightened the effectiveness of these plays as an instrument of social discussion.

Constitutive model of viscoelastic dynamic damage for the material of gas obturator in modular-charge howitzer

In order to investigate the mechanical response behavior of the gas obturator of the breech mechanism,made of polychloroprene rubber(PCR), uniaxial compression experiments were carried out by using a universal testing machine and a split Hopkinson pressure bar(SHPB), obtaining stress-strain responses at different temperatures and strain rates. The results revealed that, in comparison to other polymers, the gas obturator material exhibited inconspicuous strain softening and hardening effects;meanwhile, the mechanical response was more affected by the strain rate than by temperature. Subsequently, a succinct viscoelastic damage constitutive model was developed based on the ZWT model, including ten undetermined parameters, formulated with incorporating three parallel components to capture the viscoelastic response at high strain rate and further enhanced by integrating a three-parameter Weibull function to describe the damage. Compared to the ZWT model, the modified model could effectively describe the mechanical response behavior of the gas obturator material at high strain rates. This research laid a theoretical foundation for further investigation into the influence of chamber sealing issues on artillery firing.

Study of relationship between motion of mechanisms in gas operated weapon and its shock absorber

The article deals with the motion of the breech block carrier and the weapon casing of an automatic weapon mounted on a flexible carriage and the base of the weapon.Earlier works,which did not consider the dynamic properties of the base of the weapon,did not allow to reconcile the calculated and experimental results of the weapon casing displacement when shooting from firing rests.For the analysis of the motion of individual parts,the methods of mathematical modelling and firing experiments using a high-speed camera were chosen.Calculations show the best accord with experiment when modelling the system with 4 degrees of freedom.The oscillation of the system regarding the movement of the breech block carrier and the weapon casing was investigated under changed conditions of rate of fire,the use of a muzzle brake and different types of shock absorbers.The velocities and displacements of the weapon casing and the breech block carrier at different values of the impulse of the gases to the breech block carrier were determined.

形式追随功能:敌楼核心功能与建筑形制的关联探析

作为明长城的标志性建筑,敌楼功能与形制间的关系尚未厘清,导致类型多样化的成因和设计原则存疑、长城遗产价值揭示受阻。以明代火器为视角,史料与实物互证,分析历史上“敌楼”改名“铳楼”的原因,探索西洋火器佛郎机对敌楼核心功能的影响,通过敌楼的断代研究和“明长城全线图像与三维数据库”抽样调查,从历时性和共时性角度比较敌楼的结构与平面、箭窗与吐水嘴的位置、“悬眼”有无等形制特点,验证佛郎机与敌楼的共生关系,得出围绕核心功能的敌楼形制设计原则,拓展建筑遗产与可移动文物多元互证的研究方法,为相关遗产的价值揭示和利用提供参考。

臀位外倒转术在足月臀位妊娠产妇中的应用及矫正成功影响因素分析

目的探讨臀位外倒转术在足月臀位妊娠产妇中的应用,并分析其矫正成功影响因素。方法选取2020年1月至2023年1月收治的足月单胎臀位妊娠产妇162例,根据干预情况将其分为研究组(n=69例)和对照组(n=93例)2组。统计比较2组分娩方式、臀位矫正成功情况及治疗过程中并发症发生情况;采用单因素和多因素Logistic回归分析探讨足月臀位妊娠产妇臀位外倒转术矫正成功影响因素。结果研究组阴道分娩率和臀位矫正成功率[57/69,82.61%;47/69,68.12%]均高于对照组[2/93,2.15%;28/93,30.11%](P<0.01)。治疗过程中,研究组胎盘早剥、脐带绕颈、头盆不称发生率和围产期新生儿住院率[1/69,1.45%;2/69,2.90%;1/69,1.45%;1/69,1.45%]低于对照组[9/93,9.68%;12/93,12.90%;10/93,10.75%;11/93,11.83%](P<0.05)。多因素Logistic回归分析结果显示,新生儿体质量和产次是足月臀位妊娠产妇臀位外倒转术矫正成功的独立影响因素(P<0.05,P<0.01)。结论足月臀位妊娠产妇应用臀位外倒转术可提高阴道分娩率,降低并发症发生率,而新生儿体质量和产次是影响该技术矫正成功的主要因素。

足月臀位外倒转术成功预测模型的建立与验证

目的:建立单胎足月臀位外倒转术成功的预测模型并进行内部验证。方法:回顾分析2015年1月至2021年9月在首都医科大学附属北京妇产医院行臀位外倒转术的485例单胎臀位孕妇的临床资料,按手术结局分为成功组和失败组。采用logistic回归模型进行多因素分析,筛选出外倒术成功的影响因素作为预测因子建立预测模型,应用R软件构建预测模型的列线图。绘制受试者工作特征(ROC)曲线对模型预测性能进行评估,并运用Bootstrap法进行内部验证。结果:经产、宫缩抑制剂使用、胎儿体重<2960g、羊水指数≥11.3cm、非前壁胎盘、脐绕颈<2周是外倒转术成功的独立有利因素,纳入上述6个因素作为预测因子,建立外倒转术成功的预测模型及列线图。该预测模型的ROC曲线下面积为0.74(95%CI为0.70~0.79),此时灵敏度为71.43%,特异度为67.38%。模型的内部验证结果提示其预测曲线与临床实际曲线一致性良好。结论:基于上述预测因子建立的足月臀位外倒转术成功的预测模型具有较好的预测效能,可为临床医生进行临床咨询和选择外倒转术的适宜人群提供参考。

Effect of Stimulating the BL67 Point on Fetal Correction from Breech to Cephalic Presentation and Natural Delivery after the 36 Weeks of Pregnancy: A Randomized Clinical Trial

Objective:Various techniques are proposed for changing fetal presentation.We aimed to assess the effect of BL67 point stimulation on correcting breech presentation and natural delivery in women at 36-38 gestational weeks.Methods:A parallel single blinded randomized clinical trial was conducted on 72 eligible pregnant women with breech presentation at the 36 weeks of pregnancy.The subjects were divided into two groups-intervention(n=36)and control groups(n=36)by block randomization method.The intervention group stimulated the BL67 point by self-administration for 20 min once a day for 2 weeks.Finally,the appearance of cephalic presentation and rate of vaginal delivery was compared between the groups(n1=n2=32)using the Chi-square test and multivariate logistic regression.Results:The correction of breech to cephalic presentation occurred in 53.1% of patients in the intervention group.The adjusted relative risk(RR)for fetal correction from breech to cephalic was 1.80(RR=1.80,95%confidence interval[CI],1.13-5.17).It was shown that the stimulation of the BL67 point increased the correction of breech to cephalic presentation.In addition,the rate of vaginal delivery increased by>4-fold(RR=4.16,95%CI,2.54-6.82)by correction to cephalic presentation.Moreover,65.6%of mothers in intervention group and 90.6%in the control group underwent cesarean section.Conclusions:The stimulation of the BL67 point is a safe,inexpensive,and effective method that can be self-administered at home for fetal correction from breech to cephalic presentation in women with breech presentations during 36-38 gestational weeks.This promotes uncomplicated natural childbirth.

B超引导下行单胎臀位外倒转的有效性及安全性探讨

目的探讨B超引导下行单胎臀位外倒转的有效性及安全性。方法选取60例单胎臀位外倒转孕妇,根据臀位外倒转方法不同将孕妇分为观察组(实行B超引导下臀位外倒转)与对照组(不进行特殊处理),每组30例,比较两组胎位矫正成功率、分娩结局及胎儿不良结局情况。结果观察组胎位矫正成功率高于对照组(P<0.05)。观察组阴道分娩率73.33%高于对照组的10.00%(P<0.05)。观察组新生儿窒息、胎儿迫、脐带脱垂总发生率低于对照组,但比较差异无统计学意义(P>0.05)。结论在单胎臀位外倒转中引入B超引导下操作,能够提升臀位外倒转有效性,保证安全性,具有积极影响。

至阴穴艾灸联合超声下臀位倒转术对妊娠临床结局影响的护理研究

目的探究至阴穴艾灸联合超声下臀位倒转术对妊娠临床结局的影响。方法选取2022年1月至2023年8月在赣州市妇幼保健院定期产前检查、分娩的60例妊娠晚期单胎产妇作为研究对象,采用随机数字表法将其分为对照组(30例)和联合组(30例)。对照组采用常规护理结合超声下臀位倒转术,联合组在对照组方法的基础上加用至阴穴艾灸。比较两组的臀位矫正成功率、分娩情况、护理服务满意度、新生儿的相关情况。结果联合组产妇的臀位矫正成功率(76.67%)高于对照组(50.00%),差异有统计学意义(P<0.05);两组的分娩情况比较,差异有统计学意义(P<0.05)。两组新生儿的体重、脐动脉血糖比较,差异无统计学意义(P>0.05)。联合组新生儿的血氧分压、新生儿1 min Apgar评分高于对照组,差异有统计学意义(P<0.05)。对照组、联合组的护理服务总满意度分别为63.33%、83.33%,两组护理服务总满意度比较,差异无统计学意义(P>0.05)。结论至阴穴艾灸联合超声下臀位倒转术可提高臀位矫正成功率以及阴道分娩率,临床应用价值显著,值得推广。

改良臀位外倒转术在纠治足月单胎臀位中的临床应用

目的探讨改良臀位外倒转术在纠治足月单胎臀位中的临床应用。方法选取80例单胎妊娠且胎位为臀位孕妇,根据臀位外倒转术不同分为观察组(改良臀位外倒转术)与对照组(传统臀位外倒转术),各40例。比较两组一般资料、臀位外倒转术情况、并发症发生情况及妊娠结局。结果观察组新生儿体质量(3372.50±144.09)g重于对照组(3255.00±189.39)g,差异有统计学意义(P<0.05)。观察组臀位外倒转术(ECV)次数少于对照组,ECV总成功率(82.5%)高于对照组(62.5%),椎管内麻醉发生率(20.0%)低于对照组(47.5%),差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。观察组分娩孕周、阴道分娩率高于对照组,行ECV术与分娩的时间间隔长于对照组,新生儿出生时的Apgar评分≤7分、出生后48 h内收入院的发生率低于对照组,差异有统计学意义(P<0.05)。结论改良臀位外倒转术在纠治足月单胎臀位的总成功率高于传统臀位外倒转术,且椎管内麻醉术使用更低、妊娠结局更好,值得临床进一步推广与应用。

妊娠晚期臀位倒转术围手术期的护理效果观察

目的:分析妊娠晚期臀位倒转手术患者应用围手术期护理的临床效果。方法:研究于2021年1月至2023年6月选取上犹县妇幼保健院80例妊娠晚期胎儿臀位为观察对象,均行臀位倒转手术,随机均分为对照组与观察组,各40例。对照组患者实施常规护理,观察组患者予以围手术期护理,评价两组患者的手术应激状态与生活质量。结果:术后,两组患者的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)、血氧饱和度(SPO2)均升高,且相比对照组,观察组患者的SBP、DBP、MAP、HR均较低,SPO2较高,差异具有统计学意义(P<0.05)。术后,两组患者的生理机能、生理职能、精力、社会功能、情感职能、精神健康评分均升高,且相比对照组,观察组患者的生理机能、生理职能、精力、社会功能、情感职能、精神健康评分较高,差异具有统计学意义(P<0.05)。结论:妊娠晚期臀位倒转手术患者应用围手术期护理可在一定程度上降低患者的手术应激,提升患者的生活质量。

不同干预措施对胎儿臀位/横位孕妇母婴结局影响的网状Meta分析

背景胎儿臀位和横位如未得到及时、有效处理可能会增加剖宫产率,且增加子宫破裂等严重分娩并发症的风险,危及母胎生命。然而,对于不同干预措施的有效性对比与选择的优先次序,目前尚无统一结论。目的采用网状Meta分析方法,评价不同干预措施对孕晚期胎儿臀位/横位孕妇母婴结局的影响。方法计算机检索Cochrane Library、PubMed、Web of Science、Embase、CINAHL、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普网(VIP)、万方数据知识服务平台中关于不同干预措施对孕晚期胎儿臀位/横位孕妇母婴结局影响的随机对照试验(RCT),检索时间为建库至2022年3月。由2名研究人员独立完成文献筛选和资料提取,并进行文献质量评价。采用R 4.1.1和Stata 16.0软件进行数据分析和图形绘制,首先进行一致性检验与收敛性评估;通过累积排序概率图下面积(SUCRA)呈现不同措施成为最佳干预措施的可能。结果本研究共纳入36篇文献,包含7419名产妇。涉及的干预措施有:膝胸卧位、艾灸/刺激至阴穴和不同类型宫缩抑制剂/麻醉方式下实施外倒转术(ECV)。网状Meta分析结果显示,常规护理胎儿转为头位成功率低于艾灸/刺激至阴穴[RR=0.54,95%CI(0.32,0.86),P<0.05];无宫缩抑制剂胎儿转为头位成功率低于使用β2肾上腺素受体激动剂[RR=0.60,95%CI(0.38,0.62),P<0.05];无宫缩抑制剂、使用钙通道阻滞剂的阴道分娩率低于使用β2肾上腺素受体激动剂[RR=0.60,95%CI(0.39,0.89),P<0.05;RR=0.60,95%CI(0.39,0.95),P<0.05];ECV时无麻醉的胎儿转为头位成功率低于使用静脉麻醉[RR=0.71,95%CI(0.53,0.96),P<0.05]和椎管内麻醉[RR=0.65,95%CI(0.49,0.85),P<0.05];静脉麻醉、椎管内麻醉与不麻醉相比,可降低ECV后疼痛评分[WMD=-1.97,95%CI(-2.49,-1.46),P<0.05;WMD=-3.80,95%CI(-5.10,-2.50),P<0.05]。SUCRA排序结果显示,艾灸/刺激至阴穴、使用β2肾上腺素受体激动剂抑制宫缩、在椎管内麻醉下实施ECV是孕晚期纠正胎儿臀位/横位的较优措施。结论基于网状Meta分析结果和排序结果,艾灸/刺激至阴穴、使用β2肾上腺素受体激动剂抑制宫缩和在椎管内麻醉下实施ECV等措施对改善孕晚期胎儿臀位/横位孕妇母婴结局效果较好,但仍需高质量、大样本的研究进一步验证。

产科臀位分娩编码病例的回顾性分析

目的对某院产科臀位分娩相关疾病诊断ICD-10编码准确性进行分析,提高病案首页ICD编码质量。方法通过病案统计系统检索该院2016—2022年出院诊断ICD-10编码含O32.1、O64.1、O80.1或O83.1的所有臀位分娩病案,根据ICD-10疾病编码规则复核出院诊断的疾病编码,进行病案编码回顾性分析。结果695份病案中出院诊断编码错误的88份,错误率12.66%。结论为提高疾病编码的准确率,医院及科室应加强对疾病编码员的业务培训;编码员应加强专科业务知识的学习;在编码科室分工进行调整以后彼此之间要加强沟通,并且积极与临床科室交流沟通,努力提高医院病案首页编码准确率,更真实地还原每一份病案。

腰硬联合麻醉下臀位外倒转术成功的影响因素

目的探讨首次无麻醉下外倒转术失败的孕妇在腰硬联合麻醉下再次行外倒转术的成功率及其影响因素。方法回顾性分析2017年1月至2021年6月福建省妇幼保健院在无麻醉下行臀位外倒转术失败并自愿在腰硬联合麻醉下再次行外倒转术的89例孕妇的临床资料,将所有孕妇分为成功组和失败组。分析孕妇年龄、术前体重指数、孕龄、局部麻醉药剂量、羊水指数、产次、麻醉穿刺部位、麻醉平面、胎儿脊柱位置、胎盘位置、臀先露类型对腰硬联合麻醉下外倒转术成功率的影响。结果首次无麻醉下外倒转术失败的孕妇在腰硬联合麻醉下再次行外倒转术的成功率为42.7%。单因素分析结果显示,成功组和失败组孕妇的产次、麻醉平面比较,差异有统计学意义(P<0.05)。多因素分析结果显示,经产(β=1.948,OR=7.013,95%CI:2.289~21.484)、麻醉平面达到胸6水平(β=-1.752,OR=0.173,95%CI:0.051~0.586)是首次无麻醉下外倒转术失败在腰硬联合麻醉下再次行外倒转术成功的影响因素(P<0.05)。结论孕妇产次和麻醉平面是首次无麻醉下外倒转术失败在腰硬联合麻醉下再次行外倒转术成功的影响因素。

子宫颈扩张球囊联合小剂量催产素在臀位分娩中的应用效果分析

目的分析子宫颈扩张球囊联合小剂量催产素在臀位分娩中的应用效果。方法95例臀位分娩产妇,通过随机数字表法分为对照组(47例)和观察组(48例)。对照组产妇单用催产素促进分娩,观察组产妇应用子宫颈扩张球囊联合小剂量催产素促进分娩。比较两组产妇干预效果、产程(第一、二、三产程及总产程)、产妇并发症(产后出血、宫颈裂伤、产褥感染)发生情况及新生儿并发症(窒息、感染、胎粪便吸入综合征)发生情况。结果观察组产妇干预总有效率97.92%高于对照组的78.72%,差异具有统计学意义(P<0.05)。观察组产妇第一产程(8.86±1.43)h、第二产程(0.51±0.11)h、第三产程(0.03±0.01)h及总产程(9.40±1.55)h均短于对照组的(12.89±2.45)、(0.81±0.20)、(0.10±0.07)、(14.70±2.67)h,差异具有统计学意义(P<0.05)。观察组产妇并发症发生率4.17%低于对照组的19.15%,差异具有统计学意义(P<0.05)。观察组新生儿并发症发生率4.17%低于对照组的21.28%,差异具有统计学意义(P<0.05)。结论产妇臀位分娩期间应用子宫颈扩张球囊联合小剂量催产素促进分娩,可提高干预效果,加快产程进展,减少产妇及新生儿并发症并发症,值得临床推广。

超声引导下孕晚期臀位外倒转术成功的影响因素分析

目的探讨超声引导下孕晚期臀位外倒转术成功的影响因素。方法70例行B超引导下孕晚期臀位外倒转术的产妇,按外倒转术成功与否分为对照组(外倒转术失败,15例)和研究组(外倒转术成功,55例)。比较两组胎膜早破发生情况及分娩方式,统计不良事件发生情况,分析B超引导下孕晚期臀位外倒转术失败的原因、B超引导下孕晚期臀位外倒转术成功的影响因素。结果对照组产妇中有1例(6.67%)发生胎膜早破,15例(100.00%)产妇均择期剖宫产分娩;研究组产妇中有5例(9.09%)发生胎膜早破,3例(5.45%)择期剖宫产分娩,52例经阴道分娩;两组胎膜早破发生率比较差异无统计学意义(P>0.05);研究组产妇择期剖宫产率低于对照组,差异具有统计学意义(P<0.05)。两组均未发生新生儿窒息、急诊剖宫产等不良事件。B超引导下孕晚期臀位外倒转术产妇中失败15例,导致失败的原因有5个,最主要的2个原因是剧烈疼痛无法忍受、腹部肌肉紧张和可忍受疼痛、腹部肌肉紧张、多次失败,占比分别为46.7%、33.3%。两组胎儿预估体质量、胎臀入盆率、臀位类型、羊水指数(AFI)、产次、孕周、体质量指数(BMI)、年龄对比差异均无统计学意义(P>0.05);研究组胎头易触及率87.3%、胎盘位置非前壁率69.1%、无脐带绕颈率56.4%、低腹壁张力率74.5%均高于对照组的60.0%、40.0%、26.7%、33.3%,腹壁脂肪厚度(1.11±0.30)cm薄于对照组的(1.83±0.40)cm,差异具有统计学意义(P<0.05)。以胎头易触及与否、胎盘位置、脐带绕颈、腹壁张力、腹壁脂肪厚度为自变量,以外倒转术是否成功作为因变量,成功为1,失败为0,行多因素Logistic回归分析显示,胎头易触及、胎盘位置非前壁、无脐带绕颈、低腹壁张力、腹壁脂肪厚度薄是B超引导下孕晚期臀位外倒转术成功的独立保护因素(P<0.05)。结论臀位外倒转术属于安全性较高的手术,将臀位外倒转术应用在孕晚期单胎臀位产妇中成功率相对较高,其中手术成功的影响因素有胎头易触及、胎盘位置非前臂、无脐带绕颈、低腹壁张力、腹壁脂肪厚度薄,同时,该手术一定程度上会增加胎膜早破的风险,因此,对临床操作予以进一步规范,实施针对性干预措施,为无明显顺产禁忌的孕晚期臀位产妇应用B超引导下臀位外倒转术,能够有效提高成功率、安全性。