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外部头部版本在非顶部的第二个双胞胎-成功率,分娩方式和安全性:系统审查
Miłosz Dymon1, Michał Ciebiera2, Magdalena Zgliczyńska3
1Faculty of Medicine, Lazarski University, Warsaw, Poland.
Acta obstetricia et gynecologica Scandinavica
|December 6, 2024
概括
对非顶端第二双胞胎的外部头部版本 (ECV) 显示了64.4%的成功率,在大多数情况下导致顶端阴道分娩. 然而,有限的近期研究需要进一步的研究来证实安全性和有效性.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 产周研究 产周研究
背景情况:
- 双胞胎怀孕的最佳分娩方式是一个重大的临床挑战,受胎儿呈现的影响.
- 外部头部版本 (ECV) 是一个潜在的管理选项,用于顶部-非顶部双胞胎怀孕,旨在通过阴道分娩.
- 关于ECV的有效性和安全性的数据有限,特别是对于非脊椎第二双胞胎.
研究的目的:
- 系统地审查和综合现有数据,以应用外部头部版本 (ECV) 在非脊椎第二双胞胎.
- 评估在这个特定的双胞胎群体中与ECV相关的成功率,传递方式和不良结果.
主要方法:
- 在PubMed/MEDLINE,SCOPUS和COCHRANE数据库中使用PRISMA指南进行了系统的文献搜索,直到2024年5月.
- 包括原始的英语研究,研究非脊椎第二双胞胎中的ECV.
- 评论,案例报告,社论和会议论文被排除在外;10项研究符合最终分析标准.
主要成果:
- 总共分析了289个外部头部版本 (ECV),总体成功率为64.4%.
- 在成功的ECV病例中,91.9% (171例) 实现了顶部阴道分娩.
- 据报道,母亲和新生儿不良后果的发生率很低.
结论:
- 外部头部版本 (ECV) 似乎是非顶部第二个双胞胎的可行的管理选择,促进阴道分娩.
- 显著的局限性包括缺乏最近的研究 (大多数研究在1998年之前),小样本大小和回顾性设计.
- 进一步进行高质量的研究,包括随机对照试验,至关重要,以最终评估ECV对非脊椎第二双胞胎的安全性和成功.
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