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Multiple Pregnancy: Knowledge and Practice Patterns of Obstetricians and Gynecologists

Jane Cleary-Goldman, MD^*, Maria A. Morgan, PhD, Julian N. Robinson, MD, Mary E. D'Alton, MD^* and Jay Schulkin, PhD

From the *Division of Maternal–Fetal Medicine, Columbia University Medical Center, New York, New York; Department of Research, American College of Obstetricians and Gynecologists, Washington, DC; and Division of Maternal–Fetal Medicine, Brigham and Women's Hospital, Harvard University, Massachusetts.

OBJECTIVE: We sought to assess knowledge and practices of obstetricians regarding multiple gestation.

METHODS: A questionnaire investigating knowledge and practice patterns pertaining to multiple gestation was mailed to randomly selected American College of Obstetricians and Gynecologists (ACOG) Fellows and Junior Fellows in January 2003. Fifty-one percent (589/1,146) of the surveys were returned.

RESULTS: Statistical analysis included the responses from 430 practicing obstetricians. More than 60% rated their training regarding management of multiples as adequate. Men (56.5%) were older and had been in practice longer than females. Sixty-two percent of general obstetrician–gynecologists managed twins without input from a maternal–fetal medicine specialist. An understanding of chorionicity was less than anticipated. The majority of practitioners managed twins according to recent ACOG educational materials. They did not use prophylactic cerclage, home uterine-activity monitoring, or tocolytics. Fort-six percent encouraged prophylactic bed rest. The management of breech second twins varied.

CONCLUSION: Most obstetricians manage multiples according to current ACOG educational materials independent of maternal–fetal medicine specialists. This survey identified knowledge gaps, specifically in chorionicity, indicating the need to develop educational strategies addressing these insufficiencies.

LEVEL OF EVIDENCE: II-2

This article has been cited by other articles:

				J. P. Elliott Multiple Pregnancy: Knowledge and Practice Patterns of Obstetricians and Gynecologists Obstet. Gynecol., January 1, 2005; 105(1): 215 - 215. [Full Text] [PDF]

				J. Cleary-Goldman, M. A. Morgan, J. N. Robinson, M. E. D'alton, and J. Schulkin Multiple Pregnancy: Knowledge and Practice Patterns of Obstetricians and Gynecologists Obstet. Gynecol., January 1, 2005; 105(1): 215 - 216. [Full Text] [PDF]