产程早期成功的头外复位:1例报告及文献复习

Nusrat Batool Janjua, Birmani Sa, M. White, Sarah Siu, Asish Das
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摘要

病例:35岁女性,妊娠第7段,全阴道分娩,妊娠39周出现阵痛,胎膜完好。心电图(CTG)令人放心。诊断:经超声证实为臀位表现。治疗:患者可选择头外剖宫产(ECV)或(vs)下段剖宫产(LSCS)。她选择了ECV,这是成功的,其次是控制人工破膜。她顺产一名健康女婴,产后第1天出院回家。结论:虽然产时ECV不推荐常规应用,但在有选择的病例中仍有使用的余地。前提条件包括经验丰富的产科医生,可靠的CTG,既往阴道分娩,无产科指征进行LSCS,足够的羊水容量和完整的膜,早期分娩,以及知情的产妇同意。我们建议在执行ECV时保持手术室待命,以防出现产科并发症。
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Successful External Cephalic Version in Early Labour: A Case Report and Literature Review
Presentation: A 35 year old woman, gravida 7 para 7, all vaginal deliveries, presented with labour pains at 39 weeks’ gestation with intact membranes. Cardiotocograph (CTG) was reassuring. Diagnosis: Breech presentation was confirmed by an ultrasound. Treatment: The patient was offered options of External Cephalic Version (ECV) versus (vs) Lower Segment Caesarean Section (LSCS). She opted for ECV which was successful, followed by controlled artificial rupture of membranes. She delivered a healthy baby girl vaginally and was discharged home on day 1 postpartum. Conclusion: Although intrapartum ECV is not recommended routinely, there is a place for its judicious use in selective cases. The prerequisites include an experienced obstetrician, reassuring CTG, previous vaginal delivery, no obstetric indication for performing LSCS, adequate amniotic fluid volume with intact membranes, early labour, and informed maternal consent. We recommend keeping theatre on standby while performing ECV in case an obstetric complication arises.
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