Specialty-Based Variation in Applying Maternal-Fetal Surgery Trial Evidence.
Fetal Diagn Ther
; 42(3): 210-217, 2017.
Article
en En
| MEDLINE
| ID: mdl-28301843
ABSTRACT
INTRODUCTION:
The Management of Myelomeningocele Study (MOMS) compared prenatal with postnatal surgery for fetal myelomeningocele (MMC). We sought to understand how subspecialists interpreted the trial results and whether their practice has changed. MATERIALS ANDMETHODS:
Cross-sectional, mailed survey of 1,200 randomly selected maternal-fetal medicine (MFM) physicians, neonatologists, and pediatric surgeons.RESULTS:
Of 1,176 eligible physicians, 670 (57%) responded. Compared to postnatal closure, 33% viewed prenatal closure as "very favorable" and 60% as "somewhat favorable." Most physicians reported being more likely to recommend prenatal surgery (69%), while 28% were less likely to recommend pregnancy termination. In multivariable analysis, neonatologists were more likely to report prenatal closure as "very favorable" (OR 1.6; 95% CI 1.03-2.5). Pediatric surgeons and neonatologists were more likely to recommend prenatal closure (OR 2.1; 95% CI 1.3-3.3, and OR 2.9; 95% CI 1.8-4.6) and less likely to recommend termination (OR 3.8; 95% CI 2.2-6.7, and OR 4.7; 95% CI 2.7-8.1). In addition, physicians with a higher tolerance for prematurity were more likely to report prenatal closure as "very favorable" (OR 1.02; 95% CI 1.00-1.05).DISCUSSION:
In light of the MOMS trial, the vast majority of pediatric subspecialists and MFMs view prenatal MMC closure favorably. These attitudes vary by specialty and risk tolerance.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Actitud del Personal de Salud
/
Meningomielocele
/
Fetoscopía
Tipo de estudio:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Fetal Diagn Ther
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
OBSTETRICIA
/
PERINATOLOGIA
Año:
2017
Tipo del documento:
Article
País de afiliación:
Estados Unidos