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.