Willingness to Offer Cesarean Delivery (CD) for Fetal Indications When the Fetus Has a Common Aneuploidy by Region [27O]

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Abstract

INTRODUCTION:

This study was designed to examine the willingness of obstetricians to offer CD when the fetus has a common aneuploidy and to assess regional differences in the United States.

METHODS:

A survey was emailed to 2,875 OB-GYNs and 902 (31%) actively practicing Obstetricians responded. Respondents were categorized into U.S. Census Bureau regions based on their primary state of practice with 160 (19%) from the Northeast (NE), 263 (29%) from the Midwest (MW), 267 (32%) from the South (S), and 163 (20%) from the West (W). We asked “Would you offer CD for fetal indications to mothers carrying babies with a diagnosis of: T21? T18? T13? 45, X?” Answer choices were: Yes, No, or It depends. Chi-square tests were used to compare responses using an alpha level of 0.05.

RESULTS:

Overall regional differences emerged for Trisomy 18 and 13 (P=.04 and P=.01) with a greater proportion of respondents from the South indicating they would not offer CD (T18 - S=52%, NE=37%, MW=38%, W=42%; T13 - S=59%, NE=42%, MW=45%, W=49%). Focused pairwise comparisons revealed that respondents from the South were more likely to not offer CD for Trisomy 18 and 13 compared to respondents from the Northeast and Midwest.

CONCLUSION:

Obstetricians varied as to whether they would offer CD for fetal indications for Trisomy 18 and 13 based on region. The medical and ethical issues related to CD for aneuploid fetuses merit a national conversation to ensure that all pregnant women are afforded the opportunity to make an informed decision regarding their options for delivery management.

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