Defining standards of care in maternal-fetal medicine

Am J Obstet Gynecol. 2004 Oct;191(4):1491-6. doi: 10.1016/j.ajog.2004.06.043.

Abstract

Objective: The purpose of this study was to describe current practice patterns for 7 controversial topics in Maternal-Fetal Medicine.

Study design: An interactive survey of obstetric treatment was performed as part of a postgraduate course at the 2004 Annual Meeting of the Society for Maternal-Fetal Medicine. Seven controversial topics were addressed, which included tocolytic therapy, progesterone supplementation for the prevention of preterm birth, screening for inherited thrombophilia, cervical cerclage for a shortened cervix, treatment of preterm premature rupture of membranes, magnesium sulfate seizure prophylaxis, and dexamethasone therapy for HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome.

Results: A total of 298 obstetric care providers attended the postgraduate course. By report, most attendees were maternal-fetal medicine specialists (60.7% of respondents) who were >10 years out from specialty training (56.3% of respondents) and who were practicing in a university-based setting (52.9% of respondents). An average of 233 practitioners (range, 157-298 practitioners) answered each question. An analysis of the responses allowed for the determination of current practice patterns in the 7 controversial areas addressed.

Conclusion: Contemporary practice patterns for 7 controversial topics in obstetric medicine are described. Such surveys may be useful in defining standards of care in maternal-fetal medicine.

MeSH terms

  • Cerclage, Cervical
  • Female
  • Fetal Diseases / therapy*
  • Fetal Membranes, Premature Rupture / therapy
  • HELLP Syndrome / therapy
  • Humans
  • Obstetric Labor, Premature / prevention & control
  • Obstetrics / standards*
  • Practice Patterns, Physicians' / standards*
  • Pregnancy
  • Pregnancy Complications / therapy*
  • Pregnancy Complications, Hematologic / therapy
  • Thrombophilia / therapy
  • Tocolysis