Evaluation of the learning curve for external cephalic version using cumulative sum analysis.
10.5468/ogs.2017.60.4.343
- Author:
So Yun KIM
1
;
Jung Yeol HAN
;
Eun Hye CHANG
;
Dong Wook KWAK
;
Hyun Kyung AHN
;
Hyun Mi RYU
;
Moon Young KIM
Author Information
1. Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea. hanjungyeol055@gmail.com
- Publication Type:Original Article
- Keywords:
Amniotic fluid;
Breech presentation;
Learning curve;
Version, fetal
- MeSH:
Amniotic Fluid;
Breech Presentation;
Female;
Learning Curve*;
Learning*;
Pregnancy;
Retrospective Studies;
Version, Fetal*
- From:Obstetrics & Gynecology Science
2017;60(4):343-349
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: We evaluated the learning curve for external cephalic version (ECV) using learning curve-cumulative sum (LC-CUSUM) analysis. METHODS: This was a retrospective study involving 290 consecutive cases between October 2013 and March 2017. We evaluated the learning curve for ECV on nulli and over para 1 group using LC-CUSUM analysis on the assumption that 50% and 70% of ECV procedures succeeded by description a trend-line of quadratic function with reliable R² values. RESULTS: The overall success rate for ECV was 64.8% (188/290), while the success rate for nullipara and over para 1 groups was 56.2% (100/178) and 78.6% (88/112), respectively. ‘H’ value, that the actual failure rate does not differ from the acceptable failure rate, was −3.27 and −1.635 when considering ECV success rates of 50% and 70%, respectively. Consequently, in order to obtain a consistent 50% success rate, we would require 57 nullipara cases, and in order to obtain a consistent 70% success rate, we would require 130 nullipara cases. In contrast, 8 to 10 over para 1 cases would be required for an expected success rate of 50% and 70% on over para 1 group. CONCLUSION: Even a relatively inexperienced physician can experience success with multipara and after accumulating experience, they will manage nullipara cases. Further research is required for LC-CUSUM involving several practitioners instead of a single practitioner. This will lead to the gradual implementation of standard learning curve guidelines for ECV.
