Dilation and Evacuation Training in Maternal-Fetal Medicine Fellowships

American journal of obstetrics and gynecology (Impact Factor: 4.7). 06/2014; 210(6). DOI: 10.1016/j.ajog.2014.01.038


Many maternal-fetal medicine (MFM) specialists provide dilation and evacuation (D&E) procedures for their patients with fetal or obstetrical complications. Our study describes the D&E training opportunities available to MFM trainees during their fellowship.

Study Design
National surveys of MFM fellows and fellowship program directors assessed the availability of D&E training in fellowship. Univariate and multivariate comparisons of correlates of D&E training and provision were performed.

Of the 270 MFM fellows and 79 fellowship directors contacted, 92 (34%) and 44 (56%) responded, respectively. More than half of fellows (60/92) and almost half of fellowship programs (20/44) report organized training opportunities for D&E. Three-quarters of fellows surveyed believe that D&E training should be part of MFM fellowship, and a third of fellows who have not yet been trained would like training opportunities. Being at a fellowship that offers D&E training is associated with 7.5 times higher odds of intending to provide D&E after graduation. (p=0.005, 95% CI 1.8 – 30)

MFM physicians are in a unique position to provide termination services for their patients with pregnancy complications. Many MFMs provide D&E services during fellowship and plan to continue after graduation. MFM fellows express a strong interest in D&E training, and D&E training opportunities should be offered as a part of MFM fellowship.

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