实用妇产科杂志2025，Vol.41Issue(10)：836-841,6.
足月臀位行外倒转术的安全性和并发症分析
Safety and Complications Associated with External Cephalic Version for Term Breech Presentation
曾慧倩 1郑峥 1王乐乐 1钟俊敏 1周蓓 1颜凤 1赖毓冕1
作者信息
- 1. 广州医科大学附属妇女儿童医疗中心 广东省儿童健康与疾病临床医学研究中心产科,广东 广州 510623
- 折叠
摘要
Abstract
Objective:To evaluate the safety and complications of external cephalic version(ECV)for term breech presentation and to explore factors influencing the occurrence of ECV-related complications.Methods:Pregnant women with term breech presentation who underwent ECV(ECV group,n=751)and those who under-went direct cesarean section(CS)without ECV(CS group,n=706)at Guangzhou Women and Children's Medi-cal Center of Guangzhou Medical University,from January 1,2018,to July 31,2024,were enrolled.Differences in maternal clinical characteristics and neonatal outcomes were compared between the two groups.The ECV group was further divided into a successful ECV subgroup(n=537)and a failed ECV subgroup(n=214)to compare complication rates.Based on the presence or absence of complications,the ECV group was divided into a compli-cation subgroup(n=86)and a no-complication subgroup(n=665).Univariate analysis was performed on the clinical data of these subgroups.Statistically significant factors identified in the univariate analysis were subse-quently included in a multivariate Logistic regression analysis to identify high-risk factors for ECV complications.Results:①Among the 751 women undergoing ECV,the success rate was 71.50％(537/751).The vaginal deliv-ery rate following successful ECV was 57.26％(430/751).The overall complication rate was 11.45％(86/751),with a perinatal mortality rate of 0.13％(1/751).②There were no significant differences with regard to severe neonatal asphyxia and neonatal intensive care admission rate between ECV group and CS group(P＞0.05).③The total complication rate,incidence of cesarean delivery(CS)within 24 h,and incidence of uterine contrac-tions were significantly higher in the failed ECV group compared to the successful ECV group(P＜0.05).Howev-er,there was no statistically significant difference in the incidence of severe complications(fetal demise,placental abruption,emergency CS)between the two groups(P＞0.05).④Univariate and multivariate Logistic regression analyses revealed that three factors were associated with a reduced risk of ECV complications(P＜0.05):a high-er amniotic fluid index(AFI),non-engagement of the presenting part,and a palpable fetal head.Conversely,the use of anesthesia and the use of nifedipine as the tocolytic were associated with an increased risk of ECV compli-cations(P＜0.05).Conclusions:ECV does not increase the adverse outcomes of full-term neonates with breech presentation.But failed ECV can increase complications.Higher amniotic fluid index,not engaged of fetal presen-tation,touchable of fetal head and appropriate tocolytic agent application can reduce the complications while anes-thesia during ECV procedure can increase the complications of ECV.关键词
外倒转术/臀位/剖宫产/安全性/并发症Key words
External cephalic version/Breech presentation/Cesarean section/Safety/Complications分类
医药卫生引用本文复制引用
曾慧倩,郑峥,王乐乐,钟俊敏,周蓓,颜凤,赖毓冕..足月臀位行外倒转术的安全性和并发症分析[J].实用妇产科杂志,2025,41(10):836-841,6.
