Practices and education surrounding anticipated periviable deliveries among neonatal-perinatal medicine and maternal-fetal medicine fellowship programs

J Perinatol. 2016 Sep;36(9):699-703. doi: 10.1038/jp.2016.68. Epub 2016 May 5.

Abstract

Objectives: To explore national practices of periviable decision-making and care, and to determine and compare trainee education in this domain, within neonatal-perinatal medicine (NPP) and maternal-fetal medicine (MFMP) fellowship programs.

Study design: A 75-item survey was sent to NPP and MFMP program directors in the United States.

Results: In all, 79 of 168 surveys were completed (47%). MFMPs reported offering active interventions for bigger or more mature fetuses (versus NPPs). Variability exists in estimated frequency of simultaneous antenatal counseling by both specialties (range 0 to 90%) and of inter-specialty communication before consultation (range 5 to 100%). One-quarter of MFMPs reported no fellow education regarding periviable deliveries, versus 2% of NPPs (P=0.002); 40% of MFMPs teach fellows about periviable ethics, versus 63% of NPPs (P=0.05). NPPs more frequently utilize role modeling (P=0.01) and simulation (P=0.01) as learning methods.

Conclusion: NPPs and MFMPs report different, often asynchronous, practices and fellow education regarding antenatal counseling and resuscitation at periviability.

MeSH terms

  • Clinical Decision-Making
  • Curriculum
  • Education, Medical, Graduate
  • Fellowships and Scholarships*
  • Humans
  • Neonatology / education*
  • Obstetrics / education*
  • Perinatology / education*
  • Prenatal Care*
  • Program Evaluation
  • Surveys and Questionnaires
  • United States