Practice patterns of obstetric care in twin gestations: the value of MFM consultation

J Matern Fetal Neonatal Med. 2022 Sep;35(18):3453-3459. doi: 10.1080/14767058.2020.1821640. Epub 2020 Sep 20.

Abstract

Objectives: To evaluate the practice patterns among Lebanese obstetricians regarding obstetric care of twins and to compare selected practice patterns between general obstetricians and maternal fetal medicine physicians.

Methods: Questionnaires distributed during the annual meeting of the Lebanese Society of Obstetrics and Gynecology.

Results: Questionnaires were returned by 69.2% of the 296 physicians approached. Ten percent had fellowship training in Maternal Fetal Medicine (MFM). Thirty-nine percent perform cervical length measurement at 20-24 weeks of gestation and 34% recommend vaginal progesterone in case of a short cervix. When comparing selected practice patterns between MFM & general obstetricians, MFM specialists were less likely to perform cervical cerclage in the first trimester (5.9% versus 49%, p = .001), more likely to offer prenatal screening for aneuploidy (66.6% vs 46.4%, p = .03), less likely to use vaginal progesterone in the second trimester in the case of a short cervix (42.1% vs 61.8%, p = .04), less likely to perform serial ultrasound exam in the third trimester to assess fetal growth (50% vs 78%, p = .005) and more likely to deliver monoamniotic twins at 32-34 weeks of gestation (55% vs 37%, p = .05).

Conclusion: Because of the different background of the Lebanese physicians, MFM specialists are more likely to follow obstetric care guidelines in twin gestation.

Keywords: Twin gestation; maternal fetal medicine; obstetricians; perinatal care.

MeSH terms

  • Cervical Length Measurement
  • Female
  • Gynecology*
  • Humans
  • Obstetrics*
  • Pregnancy
  • Pregnancy, Twin
  • Progesterone
  • Referral and Consultation

Substances

  • Progesterone