Clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic review
Abstract Objective This review aimed to identify guidelines with recommendations applicable to the antenatal management of dichorionic diamniotic twin pregnancies within high-income countries, appraise their methodological quality, and discuss the similarities and variability across guidelines. Meth...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-023-05652-z |
| _version_ | 1797827291409022976 |
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| author | Caroline O’Connor Emily O’Connor Sara Leitao Shauna Barrett Keelin O’Donoghue |
| author_facet | Caroline O’Connor Emily O’Connor Sara Leitao Shauna Barrett Keelin O’Donoghue |
| author_sort | Caroline O’Connor |
| collection | DOAJ |
| description | Abstract Objective This review aimed to identify guidelines with recommendations applicable to the antenatal management of dichorionic diamniotic twin pregnancies within high-income countries, appraise their methodological quality, and discuss the similarities and variability across guidelines. Method A systematic literature review of electronic databases was performed. Manual searches of guideline repositories and websites of professional organisations were performed to identify additional guidelines. The protocol for this systematic review was registered on PROSPERO (CRD42021248586, 25 June 2021). AGREE II and AGREE-REX tools were applied to assess the quality of eligible guidelines. A narrative and thematic synthesis described and compared the guidelines and their recommendations. Results Twenty-four guidelines were included, from which 483 recommendations were identified across 4 international organisations and 12 countries. Guidelines addressed eight themes and recommendations were classified accordingly: chorionicity and dating (103 recommendations), fetal growth (105 recommendations), termination of pregnancy (12 recommendations), fetal death (13 recommendations), fetal anomalies (65 recommendations), antenatal care (65 recommendations), preterm labour (56 recommendations) and birth (54 recommendations). Guidelines showed significant variability in recommendations, with conflicting recommendations regarding non-invasive preterm testing, definitions surrounding selective fetal growth restriction, screening for preterm labour and the timing of birth. Guidelines lacked a focus on standard antenatal management of DCDA twins, management of discordant fetal anomaly and single fetal demise. Conclusions Specific guidance for dichorionic diamniotic twins is overall indistinct and access to guidance regarding the antenatal management of these pregnancies is currently difficult. Management of discordant fetal anomaly or single fetal demise needs greater consideration. |
| first_indexed | 2024-04-09T12:46:06Z |
| format | Article |
| id | doaj.art-51cfaf10e4314045b1f2a9351e506323 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-09T12:46:06Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-51cfaf10e4314045b1f2a9351e5063232023-05-14T11:31:03ZengBMCBMC Pregnancy and Childbirth1471-23932023-05-0123112310.1186/s12884-023-05652-zClinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic reviewCaroline O’Connor0Emily O’Connor1Sara Leitao2Shauna Barrett3Keelin O’Donoghue4INFANT Research Centre, University College CorkINFANT Research Centre, University College CorkPregnancy Loss Research Group, Department of Obstetrics & Gynecology, University College CorkCork University Hospital Library, Cork University HospitalINFANT Research Centre, University College CorkAbstract Objective This review aimed to identify guidelines with recommendations applicable to the antenatal management of dichorionic diamniotic twin pregnancies within high-income countries, appraise their methodological quality, and discuss the similarities and variability across guidelines. Method A systematic literature review of electronic databases was performed. Manual searches of guideline repositories and websites of professional organisations were performed to identify additional guidelines. The protocol for this systematic review was registered on PROSPERO (CRD42021248586, 25 June 2021). AGREE II and AGREE-REX tools were applied to assess the quality of eligible guidelines. A narrative and thematic synthesis described and compared the guidelines and their recommendations. Results Twenty-four guidelines were included, from which 483 recommendations were identified across 4 international organisations and 12 countries. Guidelines addressed eight themes and recommendations were classified accordingly: chorionicity and dating (103 recommendations), fetal growth (105 recommendations), termination of pregnancy (12 recommendations), fetal death (13 recommendations), fetal anomalies (65 recommendations), antenatal care (65 recommendations), preterm labour (56 recommendations) and birth (54 recommendations). Guidelines showed significant variability in recommendations, with conflicting recommendations regarding non-invasive preterm testing, definitions surrounding selective fetal growth restriction, screening for preterm labour and the timing of birth. Guidelines lacked a focus on standard antenatal management of DCDA twins, management of discordant fetal anomaly and single fetal demise. Conclusions Specific guidance for dichorionic diamniotic twins is overall indistinct and access to guidance regarding the antenatal management of these pregnancies is currently difficult. Management of discordant fetal anomaly or single fetal demise needs greater consideration.https://doi.org/10.1186/s12884-023-05652-zDichorionic diamnioticTwin pregnancyClinical practice guidelinesAntenatal management |
| spellingShingle | Caroline O’Connor Emily O’Connor Sara Leitao Shauna Barrett Keelin O’Donoghue Clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic review BMC Pregnancy and Childbirth Dichorionic diamniotic Twin pregnancy Clinical practice guidelines Antenatal management |
| title | Clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic review |
| title_full | Clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic review |
| title_fullStr | Clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic review |
| title_full_unstemmed | Clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic review |
| title_short | Clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic review |
| title_sort | clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies a systematic review |
| topic | Dichorionic diamniotic Twin pregnancy Clinical practice guidelines Antenatal management |
| url | https://doi.org/10.1186/s12884-023-05652-z |
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