| Which factors play a role in clinical decision-making in external cephalic version? | |
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MedLine Citation:
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PMID: 17957499 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To assess the clinical factors that influence the estimates of clinicians of the success of an external cephalic version(ECV), and the subsequent management decisions made by clinicians. DESIGN: We constructed 16 fictional vignettes of women with a term fetus in breech position eligible for ECV. Setting. Secondary and tertiary clinics in The Netherlands. POPULATION: Thirty-seven gynaecologists, residents and midwifes. METHODS: Sixteen case summaries concerning a hypothetical patient eligible for ECV. Potential prognostic factors that varied between the cases were parity, maternal body mass index, engagement of the fetus, amniotic fluid, fetal growth, fetal presentation and placental localisation. For each case presentation, the clinicians were asked for their inclination to perform an ECV, and whether or not they would use tocolysis. RESULTS: The estimated probabilities of success varied between 20 and 60%. The number of clinicians that would attempt an ECV varied per case between 32 and 97%. Amniotic fluid and engagement contributed 80% of the variation in the decision to perform ECV. In the case of oligohydramnios or an engaged breech, the clinicians tended not to perform an ECV. CONCLUSION: Amniotic fluid and engagement seem to be the main factors in the clinical decision-making of clinicians in ECV.This decision-making is probably experience based. Systematic knowledge of clinical prognosticators and subsequent assessment of their prognostic capacity is needed. |
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Authors:
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Marjolein Kok; Jan Willem Van Der Steeg; Ben W J Mol; Brent Opmeer; Joris A Van Der Post |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Acta obstetricia et gynecologica Scandinavica Volume: 87 ISSN: 1600-0412 ISO Abbreviation: Acta Obstet Gynecol Scand Publication Date: 2008 |
Date Detail:
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Created Date: 2008-01-03 Completed Date: 2008-01-31 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370343 Medline TA: Acta Obstet Gynecol Scand Country: Denmark |
Other Details:
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Languages: eng Pagination: 31-5 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands. mkok@amc.uva.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Amniotic Fluid Body Mass Index Breech Presentation / therapy* Decision Making* Female Fetal Development Gynecology / methods Humans Internship and Residency Logistic Models Midwifery / methods Parity Physicians Placenta / physiology Pregnancy Tocolysis / methods* Version, Fetal / methods* |
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