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

1  Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California
,
Bettina Paek
2  Eastside Maternal Fetal Medicine, Evergreen Health Hospital Fetal Therapy Program, Kirkland, Washington
,
Martin Walker
2  Eastside Maternal Fetal Medicine, Evergreen Health Hospital Fetal Therapy Program, Kirkland, Washington
,
Hui Liu
3  Division of General Academic Pediatrics, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Lorna Kwan
4  Department of Urology, University of California, Los Angeles, California
,
Rashmi Rao
1  Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California
,
Emily Scibetta
1  Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California
,
Yalda Afshar
1  Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California
,
Kerry Holliman
1  Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California
,
Thalia Wong
1  Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California
,
Lawrence D. Platt
1  Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California
5  Center for Fetal Medicine and Women's Ultrasound, Los Angeles, California
,
Christina S. Han
1  Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California Los Angeles, California
5  Center for Fetal Medicine and Women's Ultrasound, Los Angeles, California
› Author Affiliations
Funding REDCap support was provided by the Clinical and Translational Science Institute Grant (CTSI Grant UL1TR001881).
Further Information

Publication History

28 September 2019

16 December 2019

Publication Date:
30 January 2020 (online)

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.

Note

The data were presented in part at the 28th World Congress on Ultrasound in Obstetrics and Gynecology on October 20 to 24, 2018 in Singapore.


Supplementary Material