Antenatal screening tests: knowledge and practice patterns of obstetricians in Utah

We sought to assess knowledge and practices of obstetricians regarding antenatal testing and test the efficacy of continuing education via a direct mailing. In June 2004, an educational brochure entitled "New Options for Maternal Serum Screening for Birth Defects" as well as an anonymous survey pertaining to antenatal testing was sent to 241 American College of Obstetricians and Gynecologists (ACOG) Fellows and Junior Fellows residing in Utah. Data from the 85 (35%) respondents were analyzed. The majority of respondents practice obstetrics (81/85, or 95%). Of these, 67% of respondents perform sonograms routinely in their offices. Respondents were distributed evenly across all years of practice. Respondents offer HIV screening routinely (85%), but only 40% follow ACOG cystic fibrosis (CF) screening recommendations. Midtrimester serum screening is offered routinely by 89% of the respondents, but only 54% adequately understood the capabilities and limitations of the test. Questions related to the patient education brochure included in the mailing were answered correctly more often than the other questions. The brochure emphasized the usefulness of combined integrated screening for detecting Down syndrome, and 94% of respondents subsequently understood this concept. We show that in Utah, ACOG recommendations for HIV and maternal serum testing are being followed uniformly, but CF screening is still not being routinely offered. The accurate responses to questions related to an enclosed education brochure suggest that direct mailings may be useful for provider education, especially in regions where many providers practice remote from academic centers.