Defining standards of care in maternal-fetal medicine.
OBJECTIVE
The purpose of this study was to describe current practice patterns for 7 controversial topics in Maternal-Fetal Medicine.


METHODS
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.


CONCLUSIONS
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.
Norwitz
Errol R
ER
Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine, Yale-New Haven Hospital and Yale University School of Medicine, New Haven, CT, USA.
Bahtiyar
Mert O
MO
Sibai
Baha M
BM
D023802:Cerclage, Cervical; D005260:Female; D005315:Fetal Diseases / Q000628:therapy*; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy; D017359:HELLP Syndrome / Q000628:therapy; D006801:Humans; D007752:Obstetric Labor, Premature / Q000517:prevention & control; D009774:Obstetrics / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011250:Pregnancy Complications, Hematologic / Q000628:therapy; D019851:Thrombophilia / Q000628:therapy; D015145:Tocolysis