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胎儿神经学实践调查:当前实践与未来方向

Fetal Neurology Practice Survey: Current Practice and the Future Directions.

作者信息

Tarui Tomo, Venkatesan Charu, Gano Dawn, Lemmon Monica E, Mulkey Sarah B, Pardo Andrea C, Emrick Lisa, Scher Mark, Agarwal Sonika

机构信息

Division of Pediatric Neurology, Hasbro Children's Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.

出版信息

Pediatr Neurol. 2023 Aug;145:74-79. doi: 10.1016/j.pediatrneurol.2023.04.016. Epub 2023 Apr 25.

Abstract

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.

摘要

背景

胎儿神经学是一个快速发展的领域。会诊旨在进行诊断、预测,并与其他专科医生协调产前和围产期管理,同时为准父母提供咨询。实践参数和指南有限。

方法

对儿童神经科医生进行了一项包含48个问题的在线调查。问题针对当前的护理实践以及该领域公认的优先事项。

结果

美国43家机构的代表做出了回应;83%设有产前诊断中心,且大多数进行现场神经成像检查。胎儿磁共振成像的最早孕周各不相同。每年的会诊患者人数从少于20人到超过100人不等。接受亚专业培训的人数不到一半(n = 17.40%)。大多数受访者(n = 39.91%)有兴趣参与合作登记和教育项目。

结论

该调查突出了临床实践中的异质性。大型多中心和多学科合作对于收集数据至关重要,这些数据可为通过登记处对各机构评估的胎儿的结局提供信息,同时也有助于制定指南和教育材料。

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