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Multiple pregnancy: twin and triplet pregnancies [QS46]

Measuring the use of this guidance

Statement: 1

Women with a multiple pregnancy have the chorionicity and amnionicity of their pregnancy determined using ultrasound and recorded between 11 weeks 0 days and 13 weeks 6 days.

Quality standard measure: The proportion of women with a multiple pregnancy who receive an ultrasound scan between 11 weeks 0 days and 13 weeks 6 days to determine and record the chorionicity and amnionicity of their pregnancy.
What was measured: Proportion of women seen at one of the 30 participating units who reported they had the chorionicity and amnionicity of their pregnancy determined by 14 weeks.
Data collection end: August 2017
90%
Data collection end: August 2018
94%
Area covered: England
Source: Twins and Multiple Birth Association (TAMBA). NICE works the final report.


Statement: 2

Women with a multiple pregnancy have their fetuses labelled using ultrasound and recorded between 11 weeks 0 days and 13 weeks 6 days.

Quality standard measure: The proportion of women with a multiple pregnancy who have their fetuses labelled using an ultrasound scan and recorded between 11 weeks 0 days and 13 weeks 6 days.
What was measured: Proportion of women seen at one of the 30 participating units with a multiple pregnancy who have their fetuses labelled using an ultrasound scan and recorded between 11 weeks 0 days and 13 weeks 6 days.
Data collection end: August 2017
21%
Data collection end: August 2018
32%
Area covered: England
Source: Twins and Multiple Birth Association (TAMBA). NICE works the final report.


Statement: 3

Women with a multiple pregnancy are cared for by a multidisciplinary core team.

Quality standard measure: Evidence of local arrangements to ensure that women with a multiple pregnancy are cared for by a multidisciplinary core team.
What was measured: Proportion of women seen at one of the 30 participating units with a multiple pregnancy who were seen by an MDT.
Data collection end: August 2017
32%
Data collection end: August 2018
55%
Area covered: England
Source: Twins and Multiple Birth Association (TAMBA). NICE works the final report.

Quality standard measure: Evidence of local arrangements to ensure that women with a multiple pregnancy are cared for by a multidisciplinary core team.
What was measured: Proportion of women seen at one of the 30 participating units with a multiple pregnancy who were seen by a specialist obstetrician.
Data collection end: August 2017
61%
Data collection end: August 2018
67%
Area covered: England
Source: Twins and Multiple Birth Association (TAMBA). NICE works the final report.

Quality standard measure: Evidence of local arrangements to ensure that women with a multiple pregnancy are cared for by a multidisciplinary core team.
What was measured: Proportion of women seen at one of the 30 participating units with a multiple pregnancy who were seen by a specialist midwife.
Data collection end: August 2017
11%
Data collection end: August 2018
38%
Area covered: England
Source: Twins and Multiple Birth Association (TAMBA). NICE works the final report.

Quality standard measure: Evidence of local arrangements to ensure that women with a multiple pregnancy are cared for by a multidisciplinary core team.
What was measured: Proportion of women seen at one of the 30 participating units with a multiple pregnancy whose scans were undertaken by a sonographer with specialist training in multiples.
Data collection end: August 2017
24%
Data collection end: August 2018
60%
Area covered: England
Source: Twins and Multiple Birth Association (TAMBA). NICE works the final report.


Statement: 4

Women with a multiple pregnancy have a care plan that specifies the timing of appointments with the multidisciplinary core team appropriate for the chorionicity and amnionicity of their pregnancy.

Quality standard measure: The proportion of women with a multiple pregnancy who have a care plan that specifies the timing of antenatal care appointments with the multidisciplinary core team appropriate for the chorionicity and amnionicity of their pregnancy.
What was measured: Proportion of women seen at one of the 30 participating units with a multiple pregnancy who have a care plan that specifies the timing of antenatal care appointments with the multidisciplinary core team appropriate for the chorionicity and amnionicity of their pregnancy.
Data collection end: August 2017
38%
Data collection end: August 2018
56%
Area covered: England
Source: Twins and Multiple Birth Association (TAMBA). NICE works the final report.


Statement: 5

Women with a multiple pregnancy are monitored for fetal complications according to the chorionicity and amnionicity of their pregnancy.

Quality standard measure: Evidence of local arrangements to ensure that women with a multiple pregnancy are monitored for fetal complications according to the chorionicity and amnionicity of their pregnancy.
What was measured: Proportion of women seen at one of the 30 participating units with a multiple pregnancy who were monitored for fetal complications according to the chorionicity and amnionicity of their pregnancy.
Data collection end: August 2017
49%
Data collection end: August 2018
83%
Area covered: England
Source: Twins and Multiple Birth Association (TAMBA). NICE works the final report.


Statement: 7

Women with a multiple pregnancy have a discussion by 24 weeks with one or more members of the multidisciplinary core team about the risks, signs and symptoms of preterm labour and possible outcomes of preterm birth.

Quality standard measure: The proportion of women with a multiple pregnancy who have a discussion by 24 weeks with one or more members of the multidisciplinary core team about the risks, signs and symptoms of preterm labour and possible outcomes of preterm birth.
What was measured: Proportion of women seen at one of the 30 participating units with a multiple pregnancy who have a discussion by 24 weeks about preterm labour and birth.
Data collection end: August 2017
58%
Data collection end: August 2018
77%
Area covered: England
Source: Twins and Multiple Birth Association (TAMBA). NICE works the final report.


Statement: 8

Women with a multiple pregnancy have a discussion by 32 weeks with one or more members of the multidisciplinary core team about the timing of birth and possible modes of delivery so that a birth plan can be agreed.

Quality standard measure: The proportion of women with a multiple pregnancy who have a discussion with one or more members of the multidisciplinary core team by 32 weeks about the timing of birth and possible modes of delivery.
What was measured: Proportion of women seen at one of the 30 participating units with a multiple pregnancy who had a discussion by 32 weeks about the timing of birth and possible modes of delivery.
Data collection end: August 2017
68%
Data collection end: August 2018
86%
Area covered: England
Source: Twins and Multiple Birth Association (TAMBA). NICE works the final report.



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