YouTube as a Source of Patient Information on External Cephalic Version:Cross-Sectional Study

Background: With the global increase of cesarean deliveries, breech presentation is the third indication for elective cesareandelivery. Implementation of external cephalic version (ECV), in which the position of the baby is manipulated externally toprevent breech presentation at term, remains suboptimal. Increasing knowledge for caretakers and patients is beneficial in theuptake of ECV implementation. In recent decades, the internet has become the most important source of information for bothpatients and health care professionals. However, the use and availability of the internet also bring about concerns since theinformation is often not regulated or reviewed. Information needs to be understandable, correct, and easily obtainable for thepatient. Owing to its global reach, YouTube has great potential to both hinder and support spreading medical information andcan therefore be used as a tool for shared decision-making. Objective: The objective of this study was to investigate the available information on YouTube about ECV and assess thequality and usefulness of the information in the videos. Methods: A YouTube search was performed with five search terms and the first 35 results were selected for analysis. A qualityassessment scale was developed to quantify the accuracy of medical information of each video. The main outcome measure wasthe usefulness score, dividing the videos into useful, slightly useful, and not useful categories. The source of upload was dividedinto five subcategories and two broad categories of medical or nonmedical. Secondary outcomes included audience engagement,misinformation, and encouraging or discouraging ECV. Results: Among the 70 videos, only 14% (n=10) were defined as useful. Every useful video was uploaded by educationalchannels or health care professionals and 80% (8/10) were derived from a medical source. Over half of the not useful videos wereuploaded by birth attendants and vloggers. Videos uploaded by birth attendants scored the highest on audience engagement. Thepresence of misinformation was low across all groups. Two-thirds of the vloggers encouraged ECV to their viewers. Conclusions: A minor percentage of videos about ECV on YouTube are considered useful. Vloggers often encourage theiraudience to opt for ECV. Videos with higher audience engagement had a lower usefulness score compared to videos with loweraudience engagement. Sources from medically accurate videos should cooperate with sources with high audience engagementto contribute to the uptake of ECV by creating more awareness and a positive attitude of the procedure, thereby lowering thechance for a cesarean delivery due to breech presentation at term.