How experience influences in External Cephalic Version Success:
Longitudinal study
Abstract
Objective: The main objective is to compare ECV results when the
procedure is performed by an experienced dedicated team or by seniors
obstetricians. Design: Prospective longitudinal study. Setting:
Prospective analysis of ECV performed in ‘Virgen de la Arrixaca’
University Hospital between 10/1st/2018 and 12/31st/ 2019. Population or
Sample: All the patients who undergo ECV in this hospital. Methods: From
10/1st/2018 to 09/31st/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,
complications rate, and Vaginal delivery rate after ECV. Results: 122
pregnant women underwent an ECV attempt. 90 (73.8%) were performed by
Group A and 32 (26.2%) were carried out by Group B. The ECV success
rate increased from 56.3% (B) to 67.8% (A) (P=0.241). The greatest
increase in the success rate was seen in nulliparous (from 39.1% to
63.5%, P=0.043). Amniotic fluid pocket (OR=1.32; P=0.035) was
associated with ECV success. The complications rate decreased from
18.8% (B) to 6.7% (A) (P=0.049). Conclusions: The introduction of an
experienced dedicated team reduces ECV complications rate and, in
nulliparous it improves the ECV success rate. Multiparity and normal or
high amniotic fluid volume increase in the ECV success rate. Funding:
The authors received no funding for this work. Keywords: External
Cephalic Version, Super-specialization, Breech