- Open Access
Coming out ahead: the cost effectiveness of external cephalic version using spinal anesthesia
© O’Brien and Adashi; licensee BioMed Central Ltd. 2014
- Received: 2 February 2014
- Accepted: 4 February 2014
- Published: 24 February 2014
Breech presentation is encountered in 3 to 4% of term pregnancies and has been a significant driver of the increased rate of cesarean deliveries over the last 4 decades. External cephalic version (ECV) is recommended at term by most professional organizations in an effort to reduce the prospect of cesarean deliveries. The authors propose the use of regional anesthesia to increase efficacy and reduce cost in the care of patients who undergo ECV in an effort to convert a breech presentation to a vertex counterpart. Despite emerging evidence of the advantages, obstacles to more comprehensive implementation of this approach continue to exist, which include patient acceptance, provider experience, and safety concerns. The addition of tocolytics and use of regional anesthesia for secondary ECV efforts have also been considered as options to increase success and reduce cost. This is a commentary on http://www.ijhpr.org/content/3/1/5.
- Cesarean Delivery
- Spinal Anesthesia
- Regional Anesthesia
- Breech Presentation
- Placental Abruption
James A. O’Brien MD, FACOG is the Medical Director of Inpatient Obstetrics at Women and Infants Hospital of Rhode Island. He is also an Assistant Professor of Obstetrics and Gynecology (Clinical) at the Warren Alpert Medical School of Brown University.
Eli Y. Adashi MD, MS, CPE, FACOG is Professor of Medical Science at Warren Alpert Medical School of Brown University.
Secondary data analysis of hospital costs for external cephalic version under neuraxial blockade to reduce cesarean delivery for breech presentation at term: CF Weiniger MB ChB, PS Spencer PhD, Y Weiss MD MPH, G Ginsberg DrPH, Y Ezra MD.
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