We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Screening and treatment for short cervical length in pregnancy: a physician survey in the United States.
- Authors
Martell, Bridget; DiBenedetti, Dana B.; Weiss, Herman; Zhou, Xiaolei; Reynolds, Maria; Berghella, Vincenzo; Hassan, Sonia S.
- Abstract
<bold>Purpose: </bold>To evaluate how physicians in the United States (US) screen for, define, and treat a short cervix to prevent preterm birth.<bold>Methods: </bold>This was a cross-sectional, web-based survey of 500 physicians treating pregnant patients with a short cervix in the US. Respondents' geographic region was monitored to ensure balance across the nine US Census divisions.<bold>Results: </bold>Respondents were predominantly obstetrician/gynecologists (86%, 429/500; mean age 49 years). Physicians reported that a median of 90% of their pregnant patients undergo cervical length screening; 81% (407/500) use transvaginal ultrasound. Physicians consult multiple evidence sources to inform their patient care, most commonly clinical guidelines (83%; 413/500) and published research (70%; 349/500). Most physicians (98%; 490/500) reported treating pregnant patients with a short cervix; 95% (474/500) use synthetic and/or natural progestogen, alone or in combination with other treatment modalities. If reimbursement was not a concern, 47% of physicians (230/500) would choose vaginal progesterone as their preferred treatment to prevent preterm birth in all patients with a short cervix, and 45% (218/500) would choose a synthetic progestogen.<bold>Conclusion: </bold>US guidelines recommend transvaginal ultrasound for cervical length screening; 81% of physicians in this study reported using this method. Most physicians surveyed use progestogens to treat a short cervix, with approximately half choosing a synthetic progestin (45%) and half choosing natural progesterone (47%) as their preferred treatment, despite national guidelines recommending only vaginal natural progesterone for this indication. Additional physician education is required to implement current and best practices.
- Subjects
UNITED States; PREMATURE labor; LABOR complications (Obstetrics); PREMATURE infants; CERVIX uteri surgery; CERVIX uteri; THERAPEUTIC use of progestational hormones; COMPARATIVE studies; FETAL ultrasonic imaging; RESEARCH methodology; MEDICAL cooperation; MEDICAL protocols; PHYSICIANS; PSYCHOLOGY of physicians; PROGESTERONE; RESEARCH; RESEARCH funding; VAGINAL medication; EVALUATION research; CROSS-sectional method; PREVENTION; THERAPEUTICS
- Publication
Archives of Gynecology & Obstetrics, 2018, Vol 297, Issue 3, p601
- ISSN
0932-0067
- Publication type
journal article
- DOI
10.1007/s00404-017-4619-y