Fetal Neurology Practice Survey: Current Practice and the Future Directions

Tomo Tarui, Division of Pediatric Neurology, Hasbro Children's Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Charu Venkatesan, Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Dawn Gano, Department of Neurology & Pediatrics, University of California San Francisco, San Francisco, California.
Monica E. Lemmon, Department of Pediatrics and Population Health Sciences, Duke University School of Medicine.
Sarah B. Mulkey, Prenatal Pediatrics Institute, Children's National Hospital, Washington, District of Columbia; Departments of Neurology and Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Andrea C. Pardo, Division of Neurology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago Illinois.
Lisa Emrick, Department of Pediatrics, Neurology and Developmental Neuroscience, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
Mark Scher, Emeritus Full Professor Pediatrics and Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Sonika Agarwal, Division of Neurology & Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Division of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: agarwals2@chop.edu.

Document Type

Journal Article

Publication Date

8-1-2023

Journal

Pediatric neurology

Volume

145

DOI

10.1016/j.pediatrneurol.2023.04.016

Keywords

Brain; Counseling; Fetal; Fetal MRI; Neurology; Outcomes; Practice; Prognostic

Abstract

BACKGROUND: Fetal neurology is a rapidly evolving field. Consultations aim to diagnose, prognosticate, and coordinate prenatal and perinatal management along with other specialists and counsel expectant parents. Practice parameters and guidelines are limited. METHODS: A 48-question online survey was administered to child neurologists. Questions targeted current care practices and perceived priorities for the field. RESULTS: Representatives from 43 institutions in the United States responded; 83% had prenatal diagnosis centers, and the majority performed on-site neuroimaging. The earliest gestational age for fetal magnetic resonance imaging was variable. Annual consultations ranged from <20 to >100 patients. Fewer than half (n = 17.40%) were subspecialty trained. Most respondents (n = 39.91%) were interested in participating in a collaborative registry and educational initiatives. CONCLUSIONS: The survey highlights heterogeneity in clinical practice. Large multisite and multidisciplinary collaborations are essential to gather data that inform outcomes for fetuses evaluated across institutions through registries as well as creation of guidelines and educational material.

Department

Neurology

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