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A randomised trial of an intervention package designed to promote external cephalic version at term
1Academic Department of Obstetrics and Gynaecology, Women and Childrens Division, North Staffordshire Hospital NHS Trust (Maternity), Keele University, Newcastle Road, Stoke on Trent ST4 6QG, Staffordshire, UK.
Objective:
To evaluate the effectiveness of an intervention package to promote external cephalic version (ECV).
Study Design:
(1) Design and Setting--A randomised-controlled trial of 20 consultant-based maternity units in the West Midlands NHS Region. (2) Intervention Units--One consultant obstetrician from each unit was encouraged to promote changes in clinical practice within their unit. A multifaceted package including a workshop, written material, guidelines and videos was delivered to these consultants. (3) Control Units--No intervention. (4) Main Outcome Measure--The percentage of women with breech presentation at term who were offered ECV in the antenatal clinic, before and after the intervention.
Results:
Pre-intervention, there was no difference between the intervention and control units in the proportion of women offered ECV (20 and 19%, respectively). Post-intervention, the proportions were 15% in the control group and 36% in the intervention group (P=0.016).
Conclusion:
This type of intervention package can alter clinical practice and increase the proportion of women with breech presentation at term being offered ECV after the intervention.
