Äußere Wendung des Feten aus Beckenendlage in Schädellage

Abstract

Results of 1000 external versions of foetuses from breech to vertex presentation under tocolysis were evaluated. The rate of success of the versions was 52%. The success rate improved with gestational age, with increasing parity, with increasing age of the mother and her increasing body weight. The location of the placenta did not play a decisive role. The success rate of the version was remarkably good, even, in cases with small-for-gestational age foetuses and large-for-gestational age foetuses as well as in cases with a previous Caesarean section. The frequency of typical complications and the resulting Caesarean rate of 2.3% are within the acceptable limit. Up to now, from a total of more than 1,500 versions performed at the Department of Obstetrics at the Women's Hospital, Berlin-Neukölln, no death of either mother or child has occurred, which could be related to this procedure. Of course, the prerequisite for a safe version is strict adherence to the essential guidelines. The fact, that versions are not practised in all obstetrical departments, is partly due to the embarrassing lack of expert knowledge on the part of some practitioners and clinicians. In numerous cases, a moderately difficult laparotomy--which Caesarean section is in principle--with all the inevitable risks and dangers, could have been prevented, if a version had been performed.

External cephalic version: a safe procedure? A systematic review of version‐related risks

“…There were five smaller studies using epidural or spinal anesthesia and one larger study using N 2 O inhalation anesthesia that could not be included for those reasons but were otherwise comparable (55)(56)(57)(58)(59)(60). Complications in these studies were analyzed separately (Table I).…”

The first 40 years – a subjective review

“…1968 saw the introduction of combined electronic-biochemical monitoring of the fetus during labor by cardiotocography and fetal blood analysis [24]. In 1975 we performed an external version of the fetus from breech to cephalic presentation using tocolytic substances to relax the uterus [27]. In 1978 continuous disinfecting of the vagina for prevention of ascending infections, particularly after premature rupture of membranes [28,30] was introduced as an alternative measure to antibiosis.…”

Fetomaternale Makrotransfusion nach Versuch der äußeren Wendung1

“…The Kleihauer-Betke test is the method of choice to diagnose fetomaternal macrotransfusion. fahren etabliert worden, welches neben dem vaginalen Entbindungsversuch aus Beckenendlage und der primären Sectio eine gangbare Alternative darstellt [13]. Die Angaben über einen Wendungserfolg schwanken in der Literatur und liegen zwischen 48 und 77 % [12,14,15].…”