Recommendation ID
CG129/3
Question
Monitoring for intrauterine growth restriction:- What is the pattern of fetal growth in healthy twin and triplet pregnancies, and how should intrauterine growth restriction be defined in twin and triplet pregnancies?
Any explanatory notes
(if applicable)
Why this is important:- Although the guideline review found some studies relating to the identification of intrauterine growth restriction in twin and triplet pregnancies, the larger existing studies are retrospective in design and, therefore, of low quality. No evidence-based growth charts specific to twin and triplet pregnancies are available for use in the diagnosis of intrauterine growth restriction. The evidence for the effectiveness of tests for diagnosis of intrauterine growth restriction according to chorionicity of the pregnancy is limited.
There is, therefore, a need for large, prospective cohort studies to develop fetal growth charts specific to twin and triplet pregnancies. This would allow definition and diagnosis of clinically significant intrauterine growth restriction using true growth velocity and trajectories, rather than estimated fetal weight and discrepancy. The charts should distinguish between growth patterns in monochorionic, dichorionic and trichorionic pregnancies, and the research should evaluate clinical outcomes associated with particular growth patterns.

Source guidance details

Comes from guidance
Multiple pregnancy: antenatal care for twin and triplet pregnancies
Number
CG129
Date issued
September 2011

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No