Objective: To investigate the factors associated with the success rate of external cephalic version (ECV) for singleton and non-cephalic presentation pregnancies in the third trimester. Methods: A retrospective study of ECV among singleton and non-cephalic presentation pregnant women in 36-40 weeks of gestation at Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from January 2016 to June 2018 was analyzed. Results: (1) Totally, 251 cases of 358 pregnant women who underwent ECV were successful, with a total success rate of 70.1% (251/358). The success rate of multipara was 79.1% (129/163), while 62.6% (122/195) in primipara (P<0.01). The total vaginal delivery rate was 52.2% (187/358), the vaginal delivery rate of multipara was 61.3% (100/163), while 44.6% (87/195) in primipara (P<0.01). (2) Spontaneous reversion occurred in 7.6%(19/251) of ECV successful women, the rate of reversion of multipara was 10.9% (14/129), higher than that of the primipara [4.1% (5/122); P<0.01]. (3) Among the 232 pregnant women who did not reverted after successful ECV, 187 cases of successful vaginal delivery, the vaginal delivery rate was 80.6% (187/232); the vaginal delivery rate of the multipara was 87.0%(100/115), which was higher than that of the primipara [74.4%(87/117); P<0.01]. (4) The variables significantly associated with ECV success were parity, type of breech, whether fetal presentation was in pelvic or not (all P<0.05). The complication rate was 2.2% (8/358), among which the incidence of fetal distress, placental abruption and transient fetal heart abnormalities were 0.6% (2/358), 0.3% (1/358) and 1.4% (5/358) respectively. Conclusion: By close monitoring, ECV is a safe and effective procedure in selected appropriate cases, and worthy of clinical application.
目的： 探讨足月及近足月非头位行外倒转术（ECV）的成功率及影响ECV成功的因素。 方法： 收集2016年1月至2018年6月在广西壮族自治区妇幼保健院进行ECV的358例妊娠36~40周、单胎、非头位孕妇的临床资料，分析ECV的成功率及其影响因素。 结果： （1）358例孕妇行ECV，其中251例成功，总ECV成功率为70.1%；其中经产妇的ECV成功率为79.1%（129/163），高于初产妇（62.6%，122/195），两者比较，差异有统计学意义（P<0.01）；总自然分娩率为52.2%（187/358）；其中经产妇的自然分娩率为61.3%（100/163），初产妇为44.6%（87/195），两者比较，差异有统计学意义（P<0.05）。（2）行ECV成功的251例孕妇的胎儿中，自行复转为臀位19例，复转率为7.6%；其中经产妇的复转率为10.9%（14/129），高于初产妇（4.1%，5/122），两者比较，差异有统计学意义（P<0.05）。（3）行ECV成功后未复转的232例孕妇中，187例自然分娩，自然分娩率为80.6%；其中经产妇的自然分娩率为87.0%（100/115），高于初产妇（74.4%，87/117），两者比较，差异有统计学意义（P<0.05）。（4）影响ECV成功的单因素分析显示，产次、胎先露的类型、胎先露是否入盆与ECV的成功率相关（P均<0.05）。ECV的总并发症的发生率为2.2%（8/358），其中胎儿窘迫、胎盘早剥和一过性胎心异常的发生率分别为0.6%（2/358）、0.3%（1/358）和1.4%（5/358）。 结论： 选择合适的孕妇，在严密监护下实施ECV是有效的，值得临床推广应用。.
Keywords: Breech presentation; Root cause analysis; Version, fetal.