Effect of Super-Specialization in External Cephalic Version: A Comparative Study

Abstract

Background: The introduction of an experienced dedicated team is not a completely studied fact. Several studies reported a high external cephalic version (ECV) success rate when the procedure is executed by a single operator or a dedicated team. This study aims to compare the effectiveness and safety of the ECV when the procedure is performed by senior experienced obstetricians or by super-specialized professionals who composed a dedicated team. Methods: Longitudinal retrospective analysis of ECV performed in a tertiary hospital. From 1 January 2018 to 1 October 2019, ECV were performed by two senior experienced obstetricians who composed the dedicated team for ECV, designed as Group A. From 1 October 2019 to 31 December 2019, ECV was performed by two seniors obstetricians, designed as Group B. Ritodrine was administered during 30 minutes just before the procedure. Propofol was used for sedation. Results: 186 pregnant women were recruited (150 patients in group A and 36 patients in group B). ECV success rate increased from 47.2% (31.7–63.2) in Group B to 74.0% (66.6–80.5) in Group A (p = 0.002). The greatest increase in the success rate of ECV was seen in nulliparae, from 38.5% (21.8–57.6) in group B to 69.1% (59.4–77.6) (p = 0.004). Complications rate decreased from 22.2% (11.1–37.6) in Group B to 9.3% (5.5–14.8) in Group A (p = 0.032). Conclusions: The introduction of an experienced dedicated team improves ECV success rate, especially in primiparas, and it also reduces ECV complications rate.

Keywords

• sedation
• experience
• ecv
• breech presentation