Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California.
Eastside Maternal Fetal Medicine, Evergreen Health Hospital Fetal Therapy Program, Kirkland, Washington.
Am J Perinatol. 2020 Jul;37(9):890-897. doi: 10.1055/s-0039-1701027. Epub 2020 Jan 30.
This study aims to evaluate the utility of social media to distribute a patient survey on differences in management and outcomes of monochorionic-diamniotic (MCDA) pregnancies.
A cross-sectional survey was posted to an English-language MCDA twins patient-centered support group within the social media site, Facebook from April 2, 2018 to June 26, 2018. Subjects were recruited through a technique called "snowballing," whereby individuals shared the survey to assist with recruiting. Patient reported data were analyzed using Chi-square and Kruskal-Wallis's tests to explore characteristics associated with surveillance and outcomes as related to region and provider type.
Over 3 months, the post "reached" 14,288 Facebook users, among which 5,653 (40%) clicked on the post. A total of 2,357 respondents with MCDA pregnancies completed the survey. Total 1,928 (82%) were from the United States (US) and 419 (18%) from other countries. Total 85% of patients had co-management with maternal-fetal medicine (MFM), more in the US compared with the rest of the world (87 vs. 74%, < 0.01). MFM involvement led to increased adherence to biweekly ultrasounds (91 vs. 65%, < 0.01), diagnosis of monochorionicity by 12 weeks (74 vs. 69%, < 0.01) and better education about twin-twin transfusion syndrome (90 vs. 66%, < 0.01). Pregnancies with MFM involvement had a higher take-home baby rate for both babies (92 vs. 89%, < 0.01) or for at least one baby (98 vs. 93%, < 0.01) compared with those without MFM involvement.
A survey distributed via social media can be effective in evaluating real-life management and outcomes of an uncommon obstetrical diagnosis. This survey elucidates wide international variation in adherence to guidelines, management, and outcomes.
本研究旨在评估社交媒体在分发单绒毛膜-双羊膜（MCDA）妊娠管理和结局差异患者调查中的效用。
2018 年 4 月 2 日至 2018 年 6 月 26 日，在社交媒体网站 Facebook 上的一个英文 MCDA 双胞胎患者为中心的支持组中发布了一项横断面调查。通过一种称为“滚雪球”的技术招募受试者，即个人分享调查以协助招募。使用卡方检验和克鲁斯卡尔-沃利斯检验分析患者报告数据，以探讨与区域和提供者类型相关的与监测和结局相关的特征。
在 3 个月内，该帖子“覆盖”了 14288 名 Facebook 用户，其中 5653 名（40%）点击了该帖子。共有 2357 名 MCDA 妊娠患者完成了调查。其中 1928 名（82%）来自美国（US），419 名（18%）来自其他国家。85%的患者与母体胎儿医学（MFM）共同管理，美国的比例高于其他国家（87%比 74%，<0.01）。MFM 参与导致更严格地遵循两周一次的超声检查（91%比 65%，<0.01）、12 周时诊断为单绒毛膜性（74%比 69%，<0.01）以及更好地了解双胎输血综合征（90%比 66%，<0.01）。有 MFM 参与的妊娠，两个婴儿（92%比 89%，<0.01）或至少一个婴儿（98%比 93%，<0.01）的活产率更高，而没有 MFM 参与的妊娠则更低。
通过社交媒体分发的调查可以有效地评估一种罕见产科诊断的真实管理和结局。本调查阐明了指南遵守、管理和结局方面的广泛国际差异。
