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Fetal Neurology Practice Survey: Current Practice and the Future Directions
Tomo Tarui1, Charu Venkatesan2, Dawn Gano3
1Division of Pediatric Neurology, Hasbro Children's Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Insights
Fetal neurology care shows significant variation among specialists. Collaborative efforts and registries are crucial for developing consistent guidelines and improving patient outcomes in this evolving field.
Area of Science:
- Neurology
- Pediatrics
- Obstetrics
Background:
- Fetal neurology is a rapidly advancing subspecialty.
- Consultations focus on diagnosis, prognosis, and prenatal/perinatal management.
- Limited practice parameters and guidelines exist.
Purpose of the Study:
- To assess current practices and perceived priorities in fetal neurology.
- To identify areas for improvement in fetal neurology care.
Main Methods:
- A 48-question online survey was distributed to child neurologists.
- Survey questions covered current care practices and field priorities.
Main Results:
- Responses were received from 43 US institutions.
- Most centers had prenatal diagnosis and on-site neuroimaging.
- Fetal MRI gestational age varied, and consultations ranged widely.
- Less than half of respondents had subspecialty training.
- Many expressed interest in collaborative registries and education.
Conclusions:
- Clinical practice in fetal neurology is heterogeneous.
- Multisite, multidisciplinary collaborations are vital.
- Registries and educational initiatives can inform outcomes and guide development of standards.
Background:
Fetal neurology is a rapidly evolving field. Consultations aim to diagnose, prognosticate, and coordinate prenatal and perinatal management along with other specialists and counsel expectant parents. Practice parameters and guidelines are limited.
Methods:
A 48-question online survey was administered to child neurologists. Questions targeted current care practices and perceived priorities for the field.
Results:
Representatives from 43 institutions in the United States responded; 83% had prenatal diagnosis centers, and the majority performed on-site neuroimaging. The earliest gestational age for fetal magnetic resonance imaging was variable. Annual consultations ranged from <20 to >100 patients. Fewer than half (n = 17.40%) were subspecialty trained. Most respondents (n = 39.91%) were interested in participating in a collaborative registry and educational initiatives.
Conclusions:
The survey highlights heterogeneity in clinical practice. Large multisite and multidisciplinary collaborations are essential to gather data that inform outcomes for fetuses evaluated across institutions through registries as well as creation of guidelines and educational material.
