(1037) Screening for Developmental Dysplasia of the Hip Following External Cephalic Version

Breech presentation in the third trimester is an indication for screening for developmental hip dysplasia (DDH); however, external cephalic version (ECV) can obscure this information. The objective of this study was to identify whether a successful ECV delivered in cephalic presentation impacts rate of screening for and time-to-diagnosis of DDH compared to those delivered in breech presentation following an unsuccessful ECV.

Study Design: IRB approval number NMCP.2023.0002. We performed a retrospective cohort study of all patients undergoing ECV at a single tertiary-care military treatment facility from 2016 to 2022 and assessed screening rates and time-to-imaging for DDH. The primary outcome for this analysis was whether a screening imaging study for DDH was ordered before six months of age.

Results: Successful ECV was associated with a decreased likelihood of appropriate screening imaging study being ordered (60.7% vs 95.6%, p < .001). However, in those circumstances in which appropriate screening was ordered, there was no difference in completion rates (P=.42) or age at completion of the screening imaging study (P=.13). Nor was there a difference in rates of DDH diagnosed in either cohort (P=.67).

Conclusion: In a cohort of ECV procedures performed for a singleton fetus 34 weeks gestation or more, we found that a successful ECV was associated with a reduced rate of appropriate screening for DDH. This may be due to silos in care limiting transmission of relevant clinical information from the maternal care team to the pediatric care team, likely exacerbated by divides in data access within the electronic medical record.