Investigating women’s views on the management of a breech pregnancy V1

  • Research type

    Research Study

  • Full title

    How do women with a breech presentation view the management options available to them, including the use of analgesia or anaesthesia for external cephalic version?

  • IRAS ID

    145042

  • Contact name

    Steve Yentis

  • Contact email

    s.yentis@imperial.ac.uk

  • Sponsor organisation

    Chelsea and Westminster Hospital

  • Research summary

    Background

    Women undergo external cephalic version (ECV) in order to turn a baby in a breech (bottom, or feet down) presentation to a head down position. The procedure traditionally has about a 40% success rate and may be painful, issues that recent literature suggests puts some women off.
    Pain relief using a short acting morphine-like painkiller, called remifentanil, can significantly reduce the pain experienced but does not seem to improve ECV success rates. Alternatively, a spinal anaesthetic (similar to that used for a caesarean section) can be used. This increases success rates to around 60% and very effectively reduces pain; however, it is an invasive procedure with potential complications and requires a hospital stay of at least half a day.

    Aims and objectives

    We aim to perform a qualitative study to explore the views of women with a breech presentation on their management in general, and the use of anaesthesia or analgesia for ECV in particular.

    Methods

    We will use a semi-structured interview to explore the views of 10-15 expectant mothers recruited from the Breech Clinic at Chelsea and Westminster Hospital. Interviews will be recorded and then transcribed for thematic analysis by two researchers.

    Dissemination of output

    To our knowledge, this will be the first report on how women view the use of regional anaesthesia and remifentanil analgesia for ECV. In addition, we will add the views of our patient population to the existing literature concerning the management of ECV in general. We anticipate that this information will be used to plan services and to guide future research.

  • REC name

    London - City & East Research Ethics Committee

  • REC reference

    14/LO/0235

  • Date of REC Opinion

    27 Jan 2014

  • REC opinion

    Favourable Opinion