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Choosing Wisely®

Society for Maternal-Fetal Medicine

False positive and false negative results occur with cell-free DNA screening. Any positive cell-free DNA screening result should be confirmed with invasive diagnostic testing prior to a termination of pregnancy. If cell-free DNA screening is performed, adequate pretest counseling must be provided to explain the benefits and limitations.

Choosing Wisely®

Society for Maternal-Fetal Medicine

Cell-free DNA screening for the common aneuploidies is associated with a high detection rate and low false-positive rate. This screening test is also now offered for a small number of microdeletion syndromes. Most of these microdeletions are extremely rare. Given the very low prevalence of these conditions, most positive test results will be false positives, and the positive predictive value of the test is very low. Moreover, data are lacking for the performance of microdeletion screening, ...

Choosing Wisely®

Society for Maternal-Fetal Medicine

Routine midtrimester biomarker risk stratification for preterm birth (e.g., various cytokines) and preeclampsia (e.g., placental growth factor (PlGF), soluble FMS-like tyrosine kinase-1 (sFlt-1)) in asymptomatic pregnant women is not recommended due to its limited utility and poor predictive value, respectively. Importantly, employing interventions (eg, low-dose aspirin) based on screening results have not been shown to improve maternal or fetal outcomes. Furthermore, there is the potential to ...

Choosing Wisely®

American Orthopaedic Foot & Ankle Society

Orthopaedic therapeutic biologics (orthobiologics) comprise a variety of tissue grafts and autologous blood products that include platelet rich plasma (PRP) and mesenchymal stem cell treatment. Surgeons bear responsibility to offer their patients efficacious, safe and cost-effective treatments. Orthobiologic treatment can be costly and may not be covered by insurance. Patients can become financially vulnerable especially when pursuing orthobiologic treatment that extends beyond its intended ...

Choosing Wisely®

Society for Maternal-Fetal Medicine

Recommendations regarding the optimal timing of delivery seek to balance maternal and perinatal risks. Delivery before 39 0/7 weeks of gestation without medical indication has been associated with increased adverse perinatal outcomes compared with those at or beyond 39 weeks of gestation. For suspected macrosomia, the accuracy of estimated fetal weight using sonographic and clinical estimates is inherently imprecise. In addition, the data comparing delivery to expectant management for suspected ...