Novel Use of a Social-Media-Based Survey to Detect Regional Differences in Management of Monochorionic–Diamniotic Twins

Ilina D. Pluym; Bettina Paek; Martin Walker; Hui Liu; Lorna Kwan; Rashmi Rao; Emily Scibetta; Yalda Afshar; Kerry Holliman; Thalia Wong; Lawrence D. Platt; Christina S. Han

doi:10.1055/s-0039-1701027

American Journal of Perinatology, Table of Contents

Am J Perinatol 2020; 37(09): 890-897
DOI: 10.1055/s-0039-1701027

SMFM Fellowship Series Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Novel Use of a Social-Media-Based Survey to Detect Regional Differences in Management of Monochorionic–Diamniotic Twins

Authors

Ilina D. Pluym

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California
Bettina Paek

²Eastside Maternal Fetal Medicine, Evergreen Health Hospital Fetal Therapy Program, Kirkland, Washington
Martin Walker

²Eastside Maternal Fetal Medicine, Evergreen Health Hospital Fetal Therapy Program, Kirkland, Washington
Hui Liu

³Division of General Academic Pediatrics, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania
Lorna Kwan

⁴Department of Urology, University of California, Los Angeles, California
Rashmi Rao

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California
Emily Scibetta

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California
Yalda Afshar

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California
Kerry Holliman

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California
Thalia Wong

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California
Lawrence D. Platt

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California

⁵Center for Fetal Medicine and Women's Ultrasound, Los Angeles, California
Christina S. Han

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California

⁵Center for Fetal Medicine and Women's Ultrasound, Los Angeles, California

Abstract

Objective 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.

Study Design 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.

Results 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%, p < 0.01). MFM involvement led to increased adherence to biweekly ultrasounds (91 vs. 65%, p < 0.01), diagnosis of monochorionicity by 12 weeks (74 vs. 69%, p < 0.01) and better education about twin–twin transfusion syndrome (90 vs. 66%, p < 0.01). Pregnancies with MFM involvement had a higher take-home baby rate for both babies (92 vs. 89%, p < 0.01) or for at least one baby (98 vs. 93%, p < 0.01) compared with those without MFM involvement.

Conclusion 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.

Keywords

Facebook - monochorionic diamniotic - social media - survey - web-based research - twins

Full Text

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