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ECV at term

published by HelenWest

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Trusted evidence.  Informed decisions.
Better health.
Okretanje čeda
Učinci okretanja nerođenog čeda pri kraju trudnoće (oko 36. tjedna ili kasnije) da bi se izbjeglo probleme pri porodu.
U položaju zatkom čedo je prema dolje postavljeno stražnjicom umjesto glavom. Izvanjsko okretanje glavice (engl. external cephalic version, ECV) je tehnika okretanja čeda tako da se postavi glavom prema dolje. Ovaj je pregled analizirao učinke izvanjskoga okretanja glavice na djecu koja su pri kraju trudnoće (oko 36. tjedna ili kasnije) bila u položaju zatkom.
O čemu govori pregled
Koje smo dokaze našli
Našli smo 8 istraživanja (randomizirane studije) koja su uključila 1308 trudnica. Primjena tehnike izvanjskoga okretanja glavice povećala je vjerojatnost da se čeda rode glavom naprijed i smanjila su vjerojatnost utjecanja carskomu rezu.
Tip poroda
Najbolji ishod za majke i djecu je da se dijete rodi tako da glavica izađe prva. Kada se čedo nalazi u drugom položaju, povećava se rizik od komplikacija, uključivo i potrebu primjene carskoga reza.
ECV increased having a head-first vaginal birth by 42 babies per 100
If we repeated these studies, this number can be as high as 53 and as low as 30 by chance.
Bez izvanjskog okreta
S izvanjskim okretom
79 čeda od njih 100 nije se rodilo glavicom
37 čeda od njih 100 nije se rodilo glavicom
21 čedo od njih 100 rodilo se glavicom
63 čeda od njih 100 rodilo se glavicom
Caesarean section
Caesarean section rates vary greatly between countries and over time. Avoiding the need for surgery is especially important in countries with limited resources for healthcare.
ECV reduced caesarean section by 14 women per 100
If we repeated these studies, this number can be as high as 19 and as low as 6 by chance.
Without ECV
With ECV
32 women out of 100 had a caesarean section
18 women out of 100 had a caesarean section
68 women out of 100 did  not have a caesarean section
82 women out of 100 did not have caesarean section
Is ECV safe for babies?
ECV made no clear difference to the number of babies who had an Apgar score less than 7 at 5 minutes, umbilical pH less than 7.20, were admitted to the neonatal unit, or died.
These studies are too small to show if ECV is safe to use in women with low-risk pregnancies, however other types of studies suggest that it is safe. We also do not know if it should be used in high-risk cases, such as mothers who have already had a caesarean section, or who are expecting twins.
How good is the evidence?
The quality of the studies was varied. In all trials women and health professionals knew whether ECV was happening or not, which may have affected the results. There were differences between studies in the size of the benefit of ECV.
High Moderate Low Very Low
The quality of the evidence was low for perinatal death, and very low for all other outcomes.
Infographic by Helen West, Research Associate, Cochrane Pregnancy and Childbirth
E  [email protected] T  @CochranePCG
pregnancy.cochrane.org
External cephalic version for breech presentation at term
Hofmeyr GJ, Kulier R, West HM
Full review: http://ow.ly/SMRvK
This project was supported by the National Institute for Health Research, via Cochrane Infrastructure and Cochrane programme Grant (13/89/05) funding to Cochrane Pregnancy and Childbirth. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, NHS or the Department of Health.