RESUMEN
OBJECTIVE: To investigate the effect of structured didactic lectures by leaders in the field of Maternal-Fetal Medicine on reported clinical decision-making. METHODS: An interactive survey of obstetric management 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, including tocolytic therapy, progesterone supplementation for the prevention of preterm birth, screening for inherited thrombophilia, cervical cerclage for a shortened cervix, the management of preterm premature rupture of membranes, magnesium sulfate seizure prophylaxis, and dexamethasone therapy for hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. The survey was carried out before and after a series of structured didactic lectures, thereby allowing for analysis of the effect of the lectures on reported clinical decision-making. RESULTS: A total of 298 obstetric care providers attended the postgraduate course. By report, the majority of attendees were Maternal-Fetal Medicine specialists (60.7%), less than 10 years out from specialty training (56.3%), and practicing in a university-based setting (52.9%). An average of 233 practitioners (range 157-298) answered each question. Comparison of responses to the survey given before and after the lectures demonstrated significant differences, especially in the areas of tocolytic therapy and inherited thrombophilias. CONCLUSIONS: Postgraduate lectures by leaders in the field of Maternal-Fetal Medicine have significant immediate impact on reported clinical decision-making.
Asunto(s)
Actitud del Personal de Salud , Toma de Decisiones , Educación Continua , Ginecología/educación , Obstetricia/educación , Antiinflamatorios/uso terapéutico , Cerclaje Cervical , Dexametasona/uso terapéutico , Femenino , Rotura Prematura de Membranas Fetales/prevención & control , Pruebas Genéticas , Síndrome HELLP/tratamiento farmacológico , Humanos , Sulfato de Magnesio/uso terapéutico , Partería/educación , Enfermería Obstétrica/educación , Embarazo , Nacimiento Prematuro/prevención & control , Convulsiones/inducido químicamente , Convulsiones/prevención & control , Encuestas y Cuestionarios , Trombofilia/diagnóstico , Trombofilia/genética , Tocolíticos/uso terapéutico , Estados UnidosRESUMEN
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.