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Effect of super-specialization in External Cephalic Version: A comparative study
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  • Javier Sánchez Romero,
  • Fernando Araico-Rodríguez,
  • Javier Herrera-Giménez,
  • Rosa Gallego-Pozuelo,
  • Anibal Nieto-Díaz,
  • Maria lUISA Sanchez-Ferrer
Javier Sánchez Romero
Hospital Clínico Universitario Virgen de la Arrixaca

Corresponding Author:javier.sanchez14@um.es

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Fernando Araico-Rodríguez
Hospital Clínico Universitario Virgen de la Arrixaca
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Javier Herrera-Giménez
Hospital Clínico Universitario Virgen de la Arrixaca
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Rosa Gallego-Pozuelo
Universidad de Murcia Facultad de Medicina
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Anibal Nieto-Díaz
Hospital Clínico Universitario Virgen de la Arrixaca
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Maria lUISA Sanchez-Ferrer
Murcia University
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Abstract

Objective: 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. Design: Longitudinal prospective analysis. Setting: 1st of January of 2018 and 31st of December of 2019. Population: Pregnant women with non-cephalic presentation and no contraindication for vaginal delivery. Methods: Longitudinal prospective analysis of ECV performed in a tertiary hospital. From 1/1st/2018 to 10/1st/2019, ECV were performed by two senior experienced obstetricians who composed the dedicated team for ECV, designed as Group A. From 10/1st/2019 to 12/31st/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. Main Outcome Measures: ECV success rate, ECV complication rate, cesarean section 24 h after ECV. 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. 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). Complications rate decreased from 22.2% (11.1-37.6) in Group B to 9.3% (5.5-14.8) in Group A. Conclusions: The introduction of an experienced dedicated team improves ECV success rate, especially in primiparas, and it also reduces ECV complications rate. Funding: The authors received no financial support for the research, authorship, and/or publication of this article. Keywords: Sedation, Experience, ECV, Breech presentation