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
Tweetable abstract: Super-specialization provides an extra qualification
that aids to improve the ECV success rate and reduce ECV risks.