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Open Access 01-12-2010 | Study protocol

Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

Authors: Floortje Vlemmix, Ageeth N Rosman, Margot AH Fleuren, Marlies EB Rijnders, Antje Beuckens, Monique C Haak, Bettina MC Akerboom, Joke MJ Bais, Simone MI Kuppens, Dimitri N Papatsonis, Brent C Opmeer, Joris AM van der Post, Ben Willem J Mol, Marjolein Kok

Published in: BMC Pregnancy and Childbirth | Issue 1/2010

Abstract

Background

Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for Obstetrics and Gynaecology (NVOG). Implementation of ECV does not exceed 50 to 60% and probably less.

We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling.

Method/design

The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV.

The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured.

Discussion

This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term.

Trial Registration

Dutch Trial Register (NTR): 1878

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2393/10/20/prepub

Title: Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version
Authors: Floortje Vlemmix
Ageeth N Rosman
Margot AH Fleuren
Marlies EB Rijnders
Antje Beuckens
Monique C Haak
Bettina MC Akerboom
Joke MJ Bais
Simone MI Kuppens
Dimitri N Papatsonis
Brent C Opmeer
Joris AM van der Post
Ben Willem J Mol
Marjolein Kok
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: BMC Pregnancy and Childbirth / Issue 1/2010
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/1471-2393-10-20

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

Abstract

Background

Method/design

Discussion

Trial Registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method/design

Discussion

Trial Registration

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