Implementation of the new S2e guideline "first-trimester diagnostics and therapy @ 11-13 + 6 weeks of pregnancy": a survey in outpatient practices.

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusion: 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.