Choosing Wisely: Five Things Physicians and Patients Should Question

In February 2014, the Society for Maternal-Fetal Medicine (SMFM) released its list of “Five Things Physicians and Patients Should Question” in high-risk obstetrics as part of the Choosing Wisely® campaign, led by the American Board of Internal Medicine (ABIM) Foundation.  SMFM’s list includes five evidence-based recommendations that can support maternal-fetal medicine subspecialists and their patients in making wise choices about their care.  The items included in the list were developed by the SMFM Publications Committee based on a review of the literature and evidence from SMFM’s published documents.

Five Things Physicians and Patients Should Question in high-risk obstetrics

1. Don’t do an inherited thrombophilia evaluation for women with histories of pregnancy loss, intrauterine growth restriction (IUGR), preeclampsia and abruption.
2. Don’t place a cerclage in women with short cervix who are pregnant with twins.
3. Don’t offer noninvasive prenatal testing (NIPT) to low-risk patients or make irreversible decisions based on the results of this screening test.
4. Don’t screen for intrauterine growth restriction (IUGR) with Doppler blood  flow  studies.
5. Don’t use progestogens for preterm birth prevention in uncomplicated multifetal gestations.