Brownsyne Tucker Edmonds1, Fatima McKenzie1, Barrett K Robinson2. 1. a Department of Obstetrics and Gynecology , Indiana University School of Medicine , Indianapolis , IN , USA and. 2. b Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine , NorthShore University Health System, Pritzker School of Medicine, University of Chicago , Evanston , IL , USA.
Abstract
OBJECTIVE: To describe Maternal-Fetal Medicine (MFM) physicians' practice patterns for 22-week delivery management. MEHODS: Surveyed 750 randomly-sampled members of the Society of Maternal-Fetal Medicine, querying MFMs' practices and policies guiding 22-week delivery management. RESULTS: Three hundred and twenty-five (43%) MFMs responded. Nearly all (87%) would offer induction. Twenty-eight percent would order steroids, and 12% would perform cesarean for a patient desiring resuscitation. Offering induction differed significantly based on the provider's practice setting, region, religious service attendance and political affiliation. In multivariable analyses, political affiliation remained a significant predictor of offering induction (p = 0.03). CONCLUSIONS: Most MFMs offer induction for PPROM at 22 weeks. A noteworthy proportion is willing to order steroids and perform cesarean. Personal beliefs and practice characteristics may contribute to these decisions. While little is known about the efficacy of these interventions at 22 weeks, some MFMs will offer obstetrical intervention if resuscitation is intended.
OBJECTIVE: To describe Maternal-Fetal Medicine (MFM) physicians' practice patterns for 22-week delivery management. MEHODS: Surveyed 750 randomly-sampled members of the Society of Maternal-Fetal Medicine, querying MFMs' practices and policies guiding 22-week delivery management. RESULTS: Three hundred and twenty-five (43%) MFMs responded. Nearly all (87%) would offer induction. Twenty-eight percent would order steroids, and 12% would perform cesarean for a patient desiring resuscitation. Offering induction differed significantly based on the provider's practice setting, region, religious service attendance and political affiliation. In multivariable analyses, political affiliation remained a significant predictor of offering induction (p = 0.03). CONCLUSIONS: Most MFMs offer induction for PPROM at 22 weeks. A noteworthy proportion is willing to order steroids and perform cesarean. Personal beliefs and practice characteristics may contribute to these decisions. While little is known about the efficacy of these interventions at 22 weeks, some MFMs will offer obstetrical intervention if resuscitation is intended.
Authors: Waldemar A Carlo; Scott A McDonald; Avroy A Fanaroff; Betty R Vohr; Barbara J Stoll; Richard A Ehrenkranz; William W Andrews; Dennis Wallace; Abhik Das; Edward F Bell; Michele C Walsh; Abbot R Laptook; Seetha Shankaran; Brenda B Poindexter; Ellen C Hale; Nancy S Newman; Alexis S Davis; Kurt Schibler; Kathleen A Kennedy; Pablo J Sánchez; Krisa P Van Meurs; Ronald N Goldberg; Kristi L Watterberg; Roger G Faix; Ivan D Frantz; Rosemary D Higgins Journal: JAMA Date: 2011-12-07 Impact factor: 56.272
Authors: P Brian Smith; Namasivayam Ambalavanan; Lei Li; C Michael Cotten; Matthew Laughon; Michele C Walsh; Abhik Das; Edward F Bell; Waldemar A Carlo; Barbara J Stoll; Seetha Shankaran; Abbot R Laptook; Rosemary D Higgins; Ronald N Goldberg Journal: Pediatrics Date: 2012-05-28 Impact factor: 7.124
Authors: Barbara J Stoll; Nellie I Hansen; Edward F Bell; Seetha Shankaran; Abbot R Laptook; Michele C Walsh; Ellen C Hale; Nancy S Newman; Kurt Schibler; Waldemar A Carlo; Kathleen A Kennedy; Brenda B Poindexter; Neil N Finer; Richard A Ehrenkranz; Shahnaz Duara; Pablo J Sánchez; T Michael O'Shea; Ronald N Goldberg; Krisa P Van Meurs; Roger G Faix; Dale L Phelps; Ivan D Frantz; Kristi L Watterberg; Shampa Saha; Abhik Das; Rosemary D Higgins Journal: Pediatrics Date: 2010-08-23 Impact factor: 7.124