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Maternal serum screening: practice patterns of physicians in Newfoundland
Sujata Chandra1, Joan Crane, Donna Hutchens
1Department of Obstetrics and Gynecology, Memorial University of Newfoundland, St. John's, NL, Canada.
Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|October 9, 2003
Summary
Physician gender and training influence the use of second trimester maternal serum screening (MSS) in Newfoundland. Further education is needed to ensure appropriate timing and utilization of this prenatal screening test.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health
Background:
- Second trimester maternal serum screening (MSS) involves testing for alpha-fetoprotein, human chorionic gonadotropin, and unconjugated estriol.
- Understanding the factors influencing MSS utilization is crucial for optimizing prenatal care.
- Previous studies have highlighted variations in screening practices, necessitating regional analysis.
Purpose of the Study:
- To compare the utilization of second trimester maternal serum screening (MSS) in Newfoundland.
- To investigate the impact of practice location, physician training, and gender on MSS offering.
- To identify areas for improvement in the provision of prenatal screening services.
Main Methods:
- Anonymous self-reported questionnaires were distributed to practicing family physicians, general practitioners, and obstetricians in Newfoundland.
- The survey collected data on demographic characteristics, antenatal care practices, gestational age for MSS orders, and reasons for offering or not offering screening.
- Statistical analysis included chi-square and Fisher exact tests to compare categorical data.
Main Results:
- A 63% physician response rate was achieved, with 40% in urban practices.
- Female physicians were more likely to offer MSS (89% vs. 78%, P=0.04).
- Family physicians and obstetricians offered MSS more frequently than general practitioners (85%/83% vs. 25%, P=0.02).
- Practice location did not significantly impact MSS offering (P=0.41).
- 25% of family physicians offering MSS did not order it within the recommended 15-20 week gestational window.
- Routine antenatal ultrasound was offered to 94% of pregnant women.
Conclusions:
- Maternal serum screening utilization in Newfoundland is influenced by physician training and gender, not practice location.
- There is a need for enhanced physician education to ensure the appropriate and timely use of MSS.
- Optimizing MSS delivery can improve the effectiveness of prenatal diagnostic services.