{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T12:49:40Z","timestamp":1774270180966,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The rising rate of cesarean is a global public health concern. In Japan, the rate rose to 29.3% in 2023. Non\u2010cephalic fetuses are typically delivered via cesarean; however, the external cephalic version (ECV) has the potential to reduce perinatal complications and healthcare costs. This study aimed to evaluate the medical cost savings and effectiveness of ECV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study was conducted at a single perinatal center in 2023. ECV was performed under combined spinal\u2010epidural anesthesia (CSEA). The primary endpoint was cost savings from ECV from a societal perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the study period, 1332 deliveries occurred, of which 61 cases involved patients with non\u2010cephalic fetuses. Among these, 79% agreed to undergo the ECV trial, with a 93% success rate. The cost savings per successful ECV resulting in normal vaginal delivery versus one elective cesarean were 226\u2009695 yen. Compared to assuming all patients had undergone cesarean, the total delivery cost savings for ECV were 6\u2009947\u2009452 yen\/1000 deliveries. ECV adoption reduced the cesarean rate from 26.7% to 23.9%, without significant adverse perinatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ECV performed under CSEA demonstrated a reduction in the medical costs covered by health insurance along with a high success rate and a reduction in the cesarean rate. By increasing insurance reimbursements for ECV, facilities that introduce ECV may increase, which may reduce cesarean rates without increasing the burden of social costs in Japan.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70031","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T06:55:28Z","timestamp":1755759328000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Reducing medical costs by adopting external cephalic version in a single perinatal center in Japan"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4235-6780","authenticated-orcid":false,"given":"Nami","family":"Tamura","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Medicine, Juntendo University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6195-8971","authenticated-orcid":false,"given":"Jun","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Medicine, Juntendo University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshifumi","family":"Suga","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Faculty of Medicine, Juntendo University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4097-0696","authenticated-orcid":false,"given":"Asako","family":"Kumagai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Medicine, Juntendo University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nana","family":"Matsuzawa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Medicine, Juntendo University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8991-4551","authenticated-orcid":false,"given":"Yuka","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Medicine, Juntendo University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4554-164X","authenticated-orcid":false,"given":"Atsuo","family":"Itakura","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Medicine, Juntendo University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-019-2226-6"},{"key":"e_1_2_11_3_1","volume-title":"StatPearls","author":"Shanahan MM","year":"2024"},{"key":"e_1_2_11_4_1","volume-title":"Survey on Medical Institutions","author":"Ministry of Health, Labour and Welfare","year":"2020"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xagr.2024.100366"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.14390\/jsshp.HRP2020-017"},{"key":"e_1_2_11_7_1","article-title":"Planned elective repeat caesarean section versus planned vaginal birth for women with a previous caesarean birth","volume":"12","author":"Dodd JM","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31818b4ade"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2006.00702.x"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13234"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14169"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2012.663828"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003837"},{"key":"e_1_2_11_14_1","volume-title":"External cephalic version and reducing the incidence of term breech presentation (green\u2010top guideline No. 20a)","author":"Royal College of Obstetricians and Gynaecologists","year":"2017"},{"key":"e_1_2_11_15_1","volume-title":"WHO statement on caesarean section rates","author":"World Health Organization","year":"2015"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60828-3"},{"key":"e_1_2_11_17_1","first-page":"XIV","article-title":"Japan health system review","volume":"8","author":"Sakamoto H","year":"2018","journal-title":"Health Syst Transit"},{"key":"e_1_2_11_18_1","volume-title":"StatPearls","author":"Desai NM","year":"2024"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-10-3"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31828e5bc7"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/2045-4015-3-5"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2024.2305678"},{"key":"e_1_2_11_23_1","volume-title":"Medical Fee Schedule for the Fiscal Year 2024","author":"Ministry of Health, Labour and Welfare","year":"2024"},{"key":"e_1_2_11_24_1","volume-title":"Revisions of Medical Fees (Shinryo Hiyou Seido)","author":"Ministry of Health, Labour and Welfare","year":"2024"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.2019.62.6.371"}],"container-title":["Journal of Obstetrics and Gynaecology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.70031","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T01:39:06Z","timestamp":1763602746000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.70031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/jog.70031"],"URL":"https:\/\/doi.org\/10.1111\/jog.70031","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"value":"1341-8076","type":"print"},{"value":"1447-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2025-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70031"}}