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Investigating Women's Views on the Management of a Breech Pregnancy

Conditions
Presentation; Breech, Complicating Pregnancy
Registration Number
NCT02082795
Lead Sponsor
Chelsea and Westminster NHS Foundation Trust
Brief Summary

The investigators 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.

Detailed Description

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

The investigators 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

The investigators 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. The investigators anticipate that this information will be used to plan services and to guide future research.

Recruitment & Eligibility

Status
UNKNOWN
Sex
Female
Target Recruitment
15
Inclusion Criteria
  • Breech presentation
  • eligible for an external cephalic version attempt
Exclusion Criteria
  • Multiple pregnancy
  • Previous caesarean section
  • English not sufficient to carry out the interview

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Mothers' opinions on anaesthesia for external cephalic versionImmediate

This is a qualitative study using information gathered during a semi-structured interview. All information will be gathered at the time of the interview. There will be no other followup.

Secondary Outcome Measures
NameTimeMethod
Mothers' opinions on management of breech presentationImmediate

This is a qualitative study using information gathered during a semi-structured interview. All information will be gathered at the time of the interview. There will be no other followup.

Trial Locations

Locations (1)

Chelsea and Westminster Hospital

🇬🇧

London, United Kingdom

Chelsea and Westminster Hospital
🇬🇧London, United Kingdom
Angus Rivers, MBBS BSc
Sub Investigator

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