How experience influences in External Cephalic Version Success:
Longitudinal study
Javier Sánchez-Romero Ph.D.1,2, Fernando
Araico-Rodríguez Ph.D.1, Javier Herrera-Giménez
Ph.D.1, José Eliseo Blanco-Carnero
M.D.1,2, Rosa M Gallego-Pozuelo
Ph.D.1, Anibal Nieto-Díaz Professor
M.D.1,2, María Luisa Sánchez-Ferrer
M.D.1,2
1 Department of Obstetrics and Gynecology, ’Virgen de
la Arrixaca’ University Clinical Hospital, Murcia (Spain)
2 Department of Surgery, Obstetrics, and Gynecology
and Pediatrics of University of Murcia, School of Medicine, Murcia
(Spain)
Corresponding author details : Javier Sánchez-Romero
Department of Obstetrics and Gynecology, ’Virgen de la Arrixaca’
University Clinical Hospital.
Ctra. Madrid-Cartagena, s/n
30120, El Palmar (Murcia, Spain)
+34 692 573 895javier.sanchez14@um.es
Shortened running title : How experience influences in ECV
success
Tweetable abstract : An experienced dedicated team reduces ECV
complications rate and increase ECV success rate in nullipara.
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.