Delivery mode and neonatal outcome after a trial of external cephalic version (ECV): a prospective trial of vaginal breech versus cephalic delivery

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• 作者：Joscha Reinhard (1)
  Nicole S?nger (2)
  Lars Hanker (2)
  Lena Reichenbach (2)
  Juping Yuan (2)
  Eva Herrmann (3)
  Frank Louwen (2)
  
• 关键词：External cephalic version (ECV) ; Vaginal breech delivery ; Neonatal outcome ; Caesarean section rate ; Trial of labour ; Apgar score ; Mode of delivery
• 刊名：Archives of Gynecology and Obstetrics
• 出版年：2013
• 出版时间：April 2013
• 年：2013
• 卷：287
• 期：4
• 页码：663-668
• 全文大小：320KB
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• 作者单位：Joscha Reinhard (1)
  Nicole S?nger (2)
  Lars Hanker (2)
  Lena Reichenbach (2)
  Juping Yuan (2)
  Eva Herrmann (3)
  Frank Louwen (2)
  
  1. St. Marienkrankenhaus Frankfurt, Richard-Wagner Stra?e 14, 60318, Frankfurt am Main, Germany
  2. Department of Obstetrics and Gynaecology, Faculty of Medicine, Johann Wolfgang Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
  3. Institute of Biostatistics and Mathematical Modeling, Faculty of Medicine, Johann Wolfgang Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
  
• ISSN：1432-0711

文摘

Objective To examine the delivery mode and neonatal outcome after a trial of external cephalic version (ECV) procedures. Study design This is an interim analysis of an ongoing larger prospective off-centre randomised trial, which compares a clinical hypnosis intervention against neuro-linguistic programming (NLP) of women with a singleton breech foetus at or after 370/7 (259?days) weeks of gestation and normal amniotic fluid index. Main outcome measures were delivery mode and neonatal outcome. Results On the same day after the ECV procedure two patients (2?%), who had unsuccessful ECVs, had Caesarean sections (one due to vaginal bleeding and one due to pathological CTG). After the ECV procedure 40.4?% of women had cephalic presentation (n?=?38) and 58.5?% (n?=?55) remained breech presentation. One patient remained transverse presentation (n?=?1; 1.1?%). Vaginal delivery was observed by 73.7?% of cephalic presentation (n?=?28), whereas 26.3?% (n?=?10) had in-labour Caesarean sections. Of those, who selected a trial of vaginal breech delivery, 42.4?% (n?=?14) delivered vaginally and 57.6?% (n?=?19) delivered via Caesarean section. There is a statistically significant difference between the rate of vaginal birth between cephalic presentation and trial of vaginal breech delivery (p?=?0.009), however, no difference in neonatal outcome was observed. Conclusion ECV is a safe procedure and can reduce not only the rate of elective Caesarean sections due to breech presentation but also the rate of in-labour Caesarean sections even if a trial of vaginal breech delivery is attempted.