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

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. © 2020 Informa UK Limited, trading as Taylor & Francis Group.