multiple pregnancy management
Consider a 25% or greater difference in size between twins or triplets as a clinically important indicator of intrauterine growth restriction and offer referral to a tertiary level fetal medicine centre. For this guideline the areas prioritised for economic analysis were cost effectiveness of: See the full version of the original guideline for information on the health economics of specialist versus usual care and elective birth versus expectant management. Electronic copies: Available in Portable Document Format (PDF) from the, Multiple pregnancy. The data used in this model suggest that prolonging multiple pregnancies beyond 37 weeks 0 days increases the QALY loss (see Table 11.13 in the full version of the original guideline document). The management of twin and triplet pregnancies in the antenatal period. At each appointment offer an ultrasound scan, and perform weekly biophysical profile assessments and fortnightly fetal growth scans. Electronic copies: Available in PDF from the, The guidelines manual 2009. Ultrasounds for growth are typically performed monthly. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Consider scheduling ultrasound scans in twin and triplet pregnancies at a slightly later gestational age than in singleton pregnancies and be aware that the scans will take longer to perform. National Institute for Health and Clinical Excellence, Guideline Development Group (GDG) Members: Jane Anderson, Lead Sonographer, Obstetric and Gynaecology Ultrasound, Southampton University Hospitals NHS Trust; Abhijit Bhattacharyya, General Practitioner, Solihull, West Midlands and Principal Clinical Fellow, Medical Education, University of Warwick; Sandra Bosman, Specialist Midwife for Multiple Pregnancy, Royal Victoria Infirmary, Newcastle-upon-Tyne; Leanne Bricker, Consultant in Fetal and Maternal Medicine, Liverpool Women’s NHS Foundation Trust; Jane Denton, The Multiple Births Foundation (Lay member); Jane Hawdon, Consultant Neonatologist, University College London Hospitals NHS Foundation Trust; Mark Kilby, Professor of Fetal Medicine, University of Birmingham and Birmingham Women’s Foundation Trust (GDG Chair); Frances Martin, Maternity Commissioner Programme Manager, West Sussex PCT, Goring-on-Sea, West Sussex; Kirstie McKenzie-McHarg, South Warwickshire General Hospitals NHS Foundation Trust (Lay member); Manjit Randhawa, Matron for Emergency Gynaecology Unit, Antenatal Ward and High Risk Teams in Midwifery, Guy’s and St Thomas’ NHS Foundation Trust, London; Baskaran Thilaganathan, Professor in Fetal Medicine, Director of Fetal Medicine Unit, St George’s Hospital NHS Trust, London. London (UK): National Institute for Health and Clinical Excellence (NICE); 2011 Sep. 18 p. (Clinical guideline; no.
Multiple gestations, including twins, triplets or more, are often considered higher-risk pregnancies, as they account for a disproportionate share of both maternal and fetal complications and adverse pregnancy outcomes.. Read more about care and management of multiple pregnancies.
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