Schipper J, Menkhaus R, Treier A, Dütemeyer V, Biermann A L, Hillemanns P, von Kaisenberg C, Brodowski L
Dr. Schmidt-Pich und Kollegen MVZ GmbH, Georgstraße 34, 30159, Hannover, Germany.
Kinderwunschzentrum Minden, Simenonsplatz 17, 32423, Minden, Germany.
Arch Gynecol Obstet. 2025 May 27. doi: 10.1007/s00404-025-08064-w.
The objective of this study was to ascertain the awareness of the guideline since its publication, its impact on outpatient approaches, implementation, and any alterations to daily practices.
A questionnaire containing 36 items pertaining to first-trimester diagnostics and therapy was distributed to certificated gynecologists specializing in screening in Lower Saxony and East Westphalia. The questionnaire contained both multiple choice and open questions. The questions addressed information about the structure of the study population, the presentation of mandatory and optionally recommended settings for early structured fetal malformation diagnostics and echocardiography, the basic treatment regimens for first-trimester screening, and the utilization and management of non-invasive fetal test systems.
92.1% of the 38 respondents were familiar with the guideline at the time of the survey. The mandatory recommended structures are consistently displayed by 92.1-100% of participants, the remaining optional settings are displayed ranging from 7.9 to 55.3%. The majority of participants consider the combination of biochemistry and ultrasound markers as an indication for invasive diagnostics. 71.1% offer a non-invasive prenatal test in parallel with the first-trimester screening, while 65.8% of participants offer screening for preeclampsia. It was indicated by the participants that the publication of the guideline tended to have an impact on the outpatient approach to first-trimester screening. On average, the participants have modified their practice in first-trimester screening since the guideline was published.
The recommendations outlined in the guideline have achieved a high level of awareness among most outpatient specialists, thereby exerting a notable influence on the formulation of treatment algorithms. In the contemporary context of patient-centered medicine and rapidly evolving healthcare, guidelines have emerged as a pivotal instrument for the effective aggregation of information.
本研究的目的是确定该指南自发布以来的知晓情况、其对门诊诊疗方法、实施情况以及日常实践的任何改变所产生的影响。
一份包含36项关于孕早期诊断和治疗内容的问卷被分发给下萨克森州和东威斯特法伦州专门从事筛查工作的认证妇科医生。问卷包含多项选择题和开放式问题。问题涉及研究人群的结构信息、早期结构性胎儿畸形诊断和超声心动图的强制及可选推荐设置、孕早期筛查的基本治疗方案，以及无创胎儿检测系统的使用和管理。
在调查时，38名受访者中有92.1%熟悉该指南。92.1% - 100%的参与者始终展示了强制推荐的结构，其余可选设置的展示比例在7.9%至55.3%之间。大多数参与者认为生物化学和超声标志物的组合是侵入性诊断的指征。71.1%的人在孕早期筛查的同时提供无创产前检测，而65.8%的参与者提供子痫前期筛查。参与者表示，该指南的发布往往会对孕早期筛查的门诊诊疗方法产生影响。自该指南发布以来，参与者平均已改变了他们在孕早期筛查中的做法。
该指南中概述的建议在大多数门诊专科医生中已获得较高的知晓度，从而对治疗算法的制定产生了显著影响。在以患者为中心的医学和快速发展的医疗保健的当代背景下，指南已成为有效汇总信息的关键工具。
