**15. ECV: Associated costs**

A 2001 British project analyses the hospital costs derived from the external version. The purpose was to determine the difference of costs between performing an external version, a vaginal delivery or a caesarean delivery for the breech presentations. The costs were calculated for the "accepted ECV" vs. "non-accepted ECV" option. Both options included the probable emergence of adverse effects, as well as the different deliveries (breech presentation, cephalic, planned caesarean, emergency caesarean, etc.) The results proved £248-£376 saving per patient. Therefore, offering ECV implies lower hospital costs than if it was not offered. An obstetrics service offering daily ECV will be cheaper than a service which does not offer it (James et al, 2001).

A cost-benefit analysis was also carried out including the *The Term Breech Trial* data. Surprisingly, it demonstrated that healthcare costs in the caesarean group were less than those produced in the vaginal delivery group. It also proved that there were not any differences regarding parity. Even though the caesarean intrapartum costs were higher, the vaginal delivery patients need more antepartum and intrapartum care as well as the babies, who need more intensive and intermediate cares, apart from the costs related to the epidural analgesia. Many studies expressing higher healthcare costs in induced labor or oxytocin stimulation have been published (Bost, 2003). These results show that the caesarean in breech presentation at term, despite being safer, it is also cheaper than vaginal labour (Palencia et al, 2006). However, this statement cannot be taken for granted, since the analysis did not take into account the long term costs (in prospective pregnancies, for instance) as well as the maternal risks.
