The Society for Maternal-Fetal Medicine (SMFM), as part of the Choosing Wisely® campaign by the American Board of Internal Medicine (ABIM) Foundation, has, over the last year, released a list of Things Physicians and Patients Should Question. The SMFM list includes now a total of ten evidence-based recommendations that are intended to assist care providers and their patients in making wise choices about their care. Below are the ten recommendations, most recently updated in February 2016.

  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.
  6. Don’t perform routine cervical length screening for preterm birth risk assessment in asymptomatic women before 16 weeks of gestation or beyond 24 weeks of gestation.
  7. Don’t perform antenatal testing on women with the diagnosis of gestational diabetes who are well controlled by diet alone and without other indications for testing.
  8. Don’t place women, even those at high-risk, on activity restriction to prevent preterm birth.
  9. Don’t order serum aneuploidy screening after cfDNA aneuploidy screening has already been performed.
  10. Don’t perform maternal serologic studies for cytomegalovirus and toxoplasma as part of routine prenatal laboratory studies.

If you have additional questions in general or questions about a specific clinical situation, please do not hesitate to contact one of the MFM specialists at NWP for further consultation.