• EdmondsB TuckerBTDepartment of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA., F McKenzie, K S Hendrix, S M Perkins, and G D Zimet.
• Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA.
• J Perinatol. 2015 Mar 1; 35 (3): 161-6.

ObjectiveTo determine the relative influence of patients' resuscitation preferences on periviable delivery management.Study DesignSurveyed 295 obstetrician-gynecologists about managing periviable preterm premature rupture of membranes. Across 10 vignettes, we systematically varied gestational age, occupation, method of conception and resuscitation preference. Physicians rated their likelihood (0 to 10) of proceeding with induction, steroids and cesarean. Data were analyzed via conjoint analysis.ResultTwo hundred and five physician responses were included. Median ratings for management decisions were: induction 1.89; steroids 5.00; cesarean for labor 3.89; and cesarean for distress 4.11. Gestational age had the greatest influence on physician ratings across all decisions (importance values ranging from 72.6 to 86.6), followed by patient's resuscitation preference (range=9.3 to 21.4).ConclusionGestational age is weighted more heavily than patients' resuscitation preferences in obstetricians' decision making for periviable delivery management. Misalignment of antenatal management with parental resuscitation preferences may adversely affect periviable outcomes. Interventions are needed to facilitate more patient-centered decision making in periviable care.

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