External cephalic version in breech, acceptance and effectiveness

External Cephalic Version (ECV) is recommended at term breech presentation by most professional organization in an effort to reduce the prospect of cesarean deliveries, also added benefits to the population of improved quality adjusted life years. Breech presentation is encountered in 3 to 4% of term pregnancies and has a significant driver of the increased rate of cesarean deliveries over the last 4 decades. Based on many national and international literatures and studies such RaynesGreenow in Australia, Yogev in Israel in 2014 and Dutch study in 2010; two main barriers for ECV Implementation are identified 1) lack of patient’s knowledge about ECV, risks and consequences 2) the attitude and knowledge of the OBG team towards ECV. Persistent changes such as develop an implementation strategy targeted on patient counseling and information of healthcare providers, implementation of (ECV guidelines: such the combined use of a tocolytic and regional anesthesia) and evaluate the cost effectiveness in aim to improve the implementation of ECV; resulting in the need for emergency cesarean delivery are seen only in 0.3% of cases of successful ECV and the saving of a better implementation of ECV reduced the costs with 2 to 3 million euros per year for direct medical costs only.

Author(s): Eman Nimer AlDerbashi

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