Impact of simulation-based prenatal invasive procedure training on professional practice, a preliminary study.

INTRODUCTION: Amniocentesis and chorionic villus sampling remain the cornerstone of prenatal diagnosis. These procedures are associated with a risk of miscarriage estimated at approximately 0.5 %. Our team has developed a training model for performing simulation-based prenatal invasive procedures. Several simulation sessions are offered each year to obstetricians-gynecologists involved in fetal medicine in France and abroad. This simulation-based learning has already been conclusively evaluated according to levels I and II of the Kirkpatrick model. Here, we carried out a preliminary study according to level III: does participation in training in prenatal invasive procedures through simulation have an influence on professional practice? METHODS: An anonymous online survey was sent to 82 obstetricians-gynecologists who participated in the training in prenatal invasive procedures at the Antoine Béclère maternity hospital between January 1st, 2014 and December 31, 2018. This questionnaire, entitled "Evaluation of the professional impact of training in invasive procedures through simulation", included 20 quantitative and qualitative items. RESULTS: 48 (59 %) obstetricians-gynecologists responded to the questionnaire. 98 % of the participants considered that participation in the training had a significant impact on their professional practice. Half considered this impact to be major. 60 % of the former participants are now attached to a Multidisciplinary Center for Prenatal Diagnosis. CONCLUSION: Participation in training is considered by former participants to have a significant impact on their professional practice. In order to finalize the evaluation of this learning, a study of the benefits for patients and their pregnancy should be discussed.

Two separate placental masses on ultrasound do not always indicate a dichorionic pregnancy.

Monochorionic pregnancies are associated with a higher risk of perinatal morbidity and mortality than dichorionic pregnancies. Early determination of chorionicity by an ultrasound exam between 11+0 and 14+0 weeks' gestation (WG) is essential for the subsequent management of twin pregnancies. The presence of the T-sign is the most specific sign for determination of monochorionicity. During the second trimester, the presence of two distinct placental masses has a lower specificity in determining the chorionicity. We report here two cases of a monochorionic pregnancy with a bipartite placenta, suggesting that a placenta with two separate masses, each with a distinct cord insertion is not always indicative of a dichorionic pregnancy.'