Abstract：
External cephalic version (ECV) is a cost-effective and safe treatment option for breech presentation at term. Following ECV, fetal well-being is assessed via a non-stress test (NST). An alternative option to identify signs of fetal compromise is via the Doppler indices of the umbilical artery (UA), middle cerebral artery (MCA) and ductus venosus (DV). Inclusion criteria were an uncomplicated pregnancy with breech presentation at term. Doppler velocimetry of the UA, MCA and DV were performed up to 1 h before and up to 2 h after ECV. The study included 56 patients who underwent elective ECV with a success rate of 75%. After ECV, the UA S/D ratio, UA pulsatility index (PI) and UA resistance index (RI) were increased compared to before the ECV (p = 0.021, p = 0.042, and p = 0.022, respectively). There were no differences in the Doppler MCA and DV before or after ECV. All patients were discharged after the procedure. ECV is associated with changes in the UA Doppler indices that might reflect interference in placental perfusion. These changes are probably short-term and have no detrimental effects on the outcomes of uncomplicated pregnancies. ECV is safe; yet it is a stimulus or stress that can affect placental circulation. Therefore, careful case selection for ECV is important.
摘要：
头颅外型（ECV）是足月臀位表现的一种经济有效且安全的治疗选择。在ECV之后,通过非压力测试（NST）评估胎儿的健康状况。确定胎儿受损迹象的另一种选择是通过脐动脉（UA）的多普勒指数，大脑中动脉（MCA）和静脉导管（DV）。纳入标准是无并发症的妊娠，足月有臀位。UA的多普勒测速仪，MCA和DV在ECV之前1小时和之后2小时进行。该研究包括56例接受选择性ECV的患者，成功率为75％。ECV后,UAS/D比，与ECV前相比，UA搏动指数（PI）和UA阻力指数（RI）增加（分别为p=0.021，p=0.042和p=0.022）。ECV前后的多普勒MCA和DV没有差异。所有患者术后均出院。ECV与UA多普勒指数的变化有关，这可能反映了胎盘灌注的干扰。这些变化可能是短期的，对无并发症妊娠的结果没有不利影响。ECV是安全的，但它是一种刺激或压力，可以影响胎盘循环。因此,仔细选择ECV的案例很重要。
