The influence of resuscitation preferences on obstetrical management of periviable deliveries
dc.contributor.author | Edmonds, Brownsyne Tucker | |
dc.contributor.author | McKenzie, Fatima | |
dc.contributor.author | Hendrix, Kristin S. | |
dc.contributor.author | Perkins, Susan M. | |
dc.contributor.author | Zimet, Gregory D. | |
dc.contributor.department | Department of Obstetrics & Gynecology, IU School of Medicine | en_US |
dc.date.accessioned | 2016-03-04T16:10:00Z | |
dc.date.available | 2016-03-04T16:10:00Z | |
dc.date.issued | 2015-03 | |
dc.description.abstract | Objective Determine the relative influence of patient's resuscitation preferences on periviable delivery management. Methods Surveyed 295 obstetrician-gynecologists about managing periviable preterm premature rupture of membranes. Across 10 vignettes, we systematically varied gestational age; occupation; method of conception; and resuscitation preference. Physicians rated their likelihood (0-10) of proceeding with induction, steroids, and cesarean. Data were analyzed via conjoint analysis. Results 205 physician responses were included. Median ratings for management decisions were: induction 1.89; steroids 5.00; cesarean for labor 3.89; cesarean for distress 4.11. Gestational age had the greatest influence on physician ratings across all decisions (importance values ranging from 72.6-86.6), followed by patient's resuscitation preference (range= 9.3-21.4). Conclusion Gestational age is weighted more heavily than patients’ resuscitation preferences in obstetricians’ decision-making for periviable delivery management. Misalignment of antenatal management with parental resuscitation preferences may adversely affect periviable outcomes. Interventions are needed to facilitate more patient-centered decision-making in periviable care. | en_US |
dc.eprint.version | Author's manuscript | en_US |
dc.identifier.citation | Edmonds, B. T., McKenzie, F., Hendrix, K. S., Perkins, S. M., & Zimet, G. D. (2015). The influence of resuscitation preferences on obstetrical management of periviable deliveries. Journal of Perinatology : Official Journal of the California Perinatal Association, 35(3), 161–166. http://doi.org/10.1038/jp.2014.175 | en_US |
dc.identifier.issn | 0743-8346 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/8698 | |
dc.language.iso | en_US | en_US |
dc.publisher | Nature Publishing Group | en_US |
dc.relation.isversionof | 10.1038/jp.2014.175 | en_US |
dc.relation.journal | Journal of perinatology : official journal of the California Perinatal Association | en_US |
dc.rights | Publisher Policy | en_US |
dc.source | PMC | en_US |
dc.subject | Decision Making | en_US |
dc.subject | Fetal Viability | en_US |
dc.subject | Resuscitation | en_US |
dc.title | The influence of resuscitation preferences on obstetrical management of periviable deliveries | en_US |
dc.type | Article | en_US |