DETERMINING THE CLINICAL EFFICACY AND COST SAVINGS OF SUCCESSFUL EXTERNAL CEPHALIC VERSION

OBJECTIVE: The aim of this study was to determine predictors of succes sful external cephalic version and to calculate the associated cost sa vings achieved with success. STUDY DESIGN: A retrospective study of 20 3 women with singleton gestations who underwent external cephalic vers ion was performed. Descriptive, univariate, and multivariate analyses were performed on patient-specific risk data to predict successful ver sion. National claims data were used for the cost simulation.RESULTS: Higher parity (p = 0.02), transverse-oblique presentation (p = 0.001), posterior placenta (p = 0.001), and a longer duration of pregnancy (p = 0.001) significantly increased the likelihood of a successful versi on. Heavier maternal weight was negatively associated with successful version (p = 0.05). The cost simulation revealed an average savings of $2462 for each successful version. CONCLUSION: This study identifies clinical variables associated with an increased external cephalic vers ion success rate. If, in fact, successful external cephalic version re duces both maternal and fetal morbidity associated with cesarean deliv ery and, as demonstrated in this analysis, the costs associated with t he delivery, then greater effort should be made to maximize the succes s rate of external cephalic version.