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Multiple pregnancy

Clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic review

Inconsistent guidelines for managing DCDA twin pregnancies create obstacles in antenatal care. Conflicting recommendations and gaps in guidance complicate decision-making. Clear, comprehensive guidelines are essential for optimal management.

Authors

Caroline O'Connor, Emily O'Connor, Sara Leitao, Keelin O'Donoghue

Year
2023
Journal Name
BMC Pregnancy and Childbirth
Category
Journal Article
Keywords
Clinical guideline(s), Multiple pregnancy
Project

MILESTONE

Full Citation

O’Connor C, O’Connor E, Leitao S, Barrett S, O'Donoghue K. Clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic review. BMC Pregnancy and Childbirth. 2023;23:347. https://doi.org/10.1186/s12884-023-05652-z.

Link to Publication
https://doi.org/10.1186/s12884-023-05652-z

Abstract

This review examined guidelines for managing pregnancies with dichorionic diamniotic (DCDA) twins, each have their own separate placentas. The researchers found that the guidelines lacked clear and standardised recommendations, leading to inconsistencies in care. They identified differences in recommendations across various guidelines but also found areas of agreement. These variations could be attributed to the year of guideline development, the methods used to search for evidence, and the prioritization process of guideline developers. The review highlighted the need for more specific and standardised recommendations in several areas. For example, there was no consensus on the definition to identify growth discordance or growth restriction. The guidelines also lacked guidance on managing an anomaly in one of the babies or the loss of one twin. The reviewers suggested separating guidelines based on chorionicity, similar to what has been done for monochorionic twins, to better address the unique complexities of DCDA twin pregnancies. Overall, the review highlighted the challenges healthcare providers face in managing DCDA twin pregnancies due to the lack of clear and comprehensive guidelines. The authors called for improved guidelines that reflect the best available evidence and address the specific needs of these pregnancies.

Pregnancy Loss Research Group

Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, Fifth Floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland,

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