This guideline covers the additional care that should be offered to women with twin and triplet pregnancies above that routinely offered to all women during pregnancy. It aims to reduce the risk of complications and improve outcomes in the mother and infants.
It should be read in conjunction with NICE’s guideline on antenatal care.
This guideline includes recommendations on:
- determining gestational age and the number of outer membranes that surround the babies
- general care
- fetal and maternal complications
- preterm birth
- indications for referral to a specialist centre
- timing of birth
Who is it for?
- Healthcare professionals
- Commissioners and providers
- Women who are pregnant with twins or triplets and their families and carers
Is this guideline up to date?
We checked this guideline in January 2017 and we are updating the recommendations on fetal complications. We are also extending the scope to incorporate intrapartum care.
See the guideline in development page for progress on the update.
Guideline development process
This guideline was previously called multiple pregnancy: the management of twin and triplet pregnancies in the antenatal period.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.