降低非头位及剖宫产率:有质量好的证据表明ECV可降低非头位产(RR 0.46, 95% CI 0.31-0.66)及剖宫产率(RR 0.63, 95% CI 0.44-0.90),围产期死亡率无显著变化(RR 0.34, 95% CI 0.05-2.12)。[28]Hofmeyr GJ, Kulier R, West HM. External cephalic version for breech presentation at term. Cochrane Database Syst Rev. 2015;(4):CD000083.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000083.pub3/fullhttp://www.ncbi.nlm.nih.gov/pubmed/23076883?tool=bestpractice.com既往观察性研究结果提示不良结局罕见。[32]Nassar N, Roberts CL, Barratt A, et al. Systematic review of adverse outcomes of external cephalic version and persisting breech presentation at term. Paediatr Perinat Epidemiol. 2006;20:163-171.http://www.ncbi.nlm.nih.gov/pubmed/16466434?tool=bestpractice.com[33]Nassar N, Roberts CL, Cameron CA, et al. Outcomes of external cephalic version and breech presentation at term: an audit of deliveries at a Sydney tertiary obstetric hospital, 1997-2004. Acta Obstet Gynecol Scand. 2006;85:1231-1238.http://www.ncbi.nlm.nih.gov/pubmed/17068683?tool=bestpractice.com[34]Ghidini A, Korker V. Fetal complication after external cephalic version at term: case report and literature review. J Matern Fetal Med. 1999;8:190-192.http://www.ncbi.nlm.nih.gov/pubmed/10406304?tool=bestpractice.com[35]Collins S, Ellaway P, Harrington D, et al. The complications of external cephalic version: results from 805 consecutive attempts. BJOG. 2007;114:636-638.http://www.ncbi.nlm.nih.gov/pubmed/17355270?tool=bestpractice.com[36]Grootscholten K, Kok M, Oei SG, et al. External cephalic version-related risks: a meta-analysis. Obstet Gynecol. 2008;112:1143-1151.http://www.ncbi.nlm.nih.gov/pubmed/18978117?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
降低非头位及剖宫产率:有质量好的证据表明ECV可降低非头位产(RR 0.46, 95% CI 0.31-0.66)及剖宫产率(RR 0.63, 95% CI 0.44-0.90),围产期死亡率无显著变化(RR 0.34, 95% CI 0.05-2.12)。[28]Hofmeyr GJ, Kulier R, West HM. External cephalic version for breech presentation at term. Cochrane Database Syst Rev. 2015;(4):CD000083.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000083.pub3/fullhttp://www.ncbi.nlm.nih.gov/pubmed/23076883?tool=bestpractice.com既往观察性研究结果提示不良结局罕见。[32]Nassar N, Roberts CL, Barratt A, et al. Systematic review of adverse outcomes of external cephalic version and persisting breech presentation at term. Paediatr Perinat Epidemiol. 2006;20:163-171.http://www.ncbi.nlm.nih.gov/pubmed/16466434?tool=bestpractice.com[33]Nassar N, Roberts CL, Cameron CA, et al. Outcomes of external cephalic version and breech presentation at term: an audit of deliveries at a Sydney tertiary obstetric hospital, 1997-2004. Acta Obstet Gynecol Scand. 2006;85:1231-1238.http://www.ncbi.nlm.nih.gov/pubmed/17068683?tool=bestpractice.com[34]Ghidini A, Korker V. Fetal complication after external cephalic version at term: case report and literature review. J Matern Fetal Med. 1999;8:190-192.http://www.ncbi.nlm.nih.gov/pubmed/10406304?tool=bestpractice.com[35]Collins S, Ellaway P, Harrington D, et al. The complications of external cephalic version: results from 805 consecutive attempts. BJOG. 2007;114:636-638.http://www.ncbi.nlm.nih.gov/pubmed/17355270?tool=bestpractice.com[36]Grootscholten K, Kok M, Oei SG, et al. External cephalic version-related risks: a meta-analysis. Obstet Gynecol. 2008;112:1143-1151.http://www.ncbi.nlm.nih.gov/pubmed/18978117?tool=bestpractice.com
降低围产期死亡率及新生儿并发症发病率:有质量好的证据表明,有计划的剖宫产可显著降低围产期死亡率及新生儿并发症发病率 (RR 0.33, 95 % CI 0.19-0.56)。[29]Hofmeyr GJ, Hannah M, Lawrie TA. Planned caesarean section for term breech delivery. Cochrane Database Syst Rev. 2015;(7):CD000166.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000166.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/12917886?tool=bestpractice.com在发达国家,以上结果显著改变了足月持续臀位的处理,几乎所有孕妇选择剖宫产。[46]Roberts CL, Nassar N, Raynes-Greenow CH, et al. Update on the management of term breech deliveries in NSW, Australia. Aust N Z J Obstet Gynaecol. 2003;43:173.http://www.ncbi.nlm.nih.gov/pubmed/14712980?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
降低围产期死亡率及新生儿并发症发病率:有质量好的证据表明,有计划的剖宫产可显著降低围产期死亡率及新生儿并发症发病率 (RR 0.33, 95 % CI 0.19-0.56)。[29]Hofmeyr GJ, Hannah M, Lawrie TA. Planned caesarean section for term breech delivery. Cochrane Database Syst Rev. 2015;(7):CD000166.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000166.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/12917886?tool=bestpractice.com在发达国家,以上结果显著改变了足月持续臀位的处理,几乎所有孕妇选择剖宫产。[46]Roberts CL, Nassar N, Raynes-Greenow CH, et al. Update on the management of term breech deliveries in NSW, Australia. Aust N Z J Obstet Gynaecol. 2003;43:173.http://www.ncbi.nlm.nih.gov/pubmed/14712980?tool=bestpractice.com
外倒转术成功率:一项中等质量的研究数据表明,人种、产次、子宫顺应性、羊水量、胎盘后壁、臀先露未衔接、完全性臀位、胎头可触及、羊水指数>10、孕妇体重<65kg以及宫缩抑制剂的使用均会影响成功率。[30]Royal College of Obstetricians and Gynaecologists. External cephalic version and reducing the incidence of breech presentation. December 2006. http://www.rcog.org.uk (last accessed 16 March 2016).https://www.rcog.org.uk/globalassets/documents/guidelines/gt20aexternalcephalicversion.pdf[38]Kok M, Cnossen J, Gravendeel L, et al. Clinical factors to predict the outcome of external cephalic version: a metaanalysis. Am J Obstet Gynecol. 2008;199:630.e1-e7.http://www.ncbi.nlm.nih.gov/pubmed/18456227?tool=bestpractice.com[39]Kok M, Cnossen J, Gravendeel L, et al. Ultrasound factors to
predict the outcome of external cephalic version: a meta-analysis. Ultrasound
Obstet Gynecol. 2009;33:76-84.http://www.ncbi.nlm.nih.gov/pubmed/ 19115237?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
外倒转术成功率:一项中等质量的研究数据表明,人种、产次、子宫顺应性、羊水量、胎盘后壁、臀先露未衔接、完全性臀位、胎头可触及、羊水指数>10、孕妇体重<65kg以及宫缩抑制剂的使用均会影响成功率。[30]Royal College of Obstetricians and Gynaecologists. External cephalic version and reducing the incidence of breech presentation. December 2006. http://www.rcog.org.uk (last accessed 16 March 2016).https://www.rcog.org.uk/globalassets/documents/guidelines/gt20aexternalcephalicversion.pdf[38]Kok M, Cnossen J, Gravendeel L, et al. Clinical factors to predict the outcome of external cephalic version: a metaanalysis. Am J Obstet Gynecol. 2008;199:630.e1-e7.http://www.ncbi.nlm.nih.gov/pubmed/18456227?tool=bestpractice.com[39]Kok M, Cnossen J, Gravendeel L, et al. Ultrasound factors to
predict the outcome of external cephalic version: a meta-analysis. Ultrasound
Obstet Gynecol. 2009;33:76-84.http://www.ncbi.nlm.nih.gov/pubmed/ 19115237?tool=bestpractice.com
新生儿并发症发病率:一项质量不好的证据指出,在提高5分钟Apgar评分,降低新生儿插管率,或降低早产儿颅内出血率方面,择期剖宫产(elective caesarean delivery)不比选择性剖宫产(selective caesarean delivery)更有效。
系统评价或者受试者>200名的随机对照临床试验(RCT)。
新生儿并发症发病率:一项质量不好的证据指出,在提高5分钟Apgar评分,降低新生儿插管率,或降低早产儿颅内出血率方面,择期剖宫产(elective caesarean delivery)不比选择性剖宫产(selective caesarean delivery)更有效。