Guideline No. 428: Management of Dichorionic Twin Pregnancies

Abstract

Objective: To review evidence-based recommendations for the management of dichorionic twin pregnancies.

Target population: Pregnant women with a dichorionic twin pregnancy.

Benefits, harms, and costs: Implementation of the recommendations in this guideline may improve the management of twin pregnancies and reduce neonatal and maternal morbidity and mortality.

Evidence: Published literature was retrieved through searches of PubMed and the Cochrane Library using appropriate controlled vocabulary (e.g., twin, preterm birth). Results were restricted to systematic reviews, randomized controlled trials, controlled clinical trials, and observational studies. There were no date limits, but results were limited to English- or French-language materials.

Validation methods: The content and recommendations were drafted and agreed upon by the principal authors. The Board of the SOGC approved the final draft for publication. The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations).

Intended audience: Obstetricians, family physicians, nurses, midwives, maternal-fetal medicine specialists, radiologists, and other health care providers who care for women with twin pregnancies.

Summary statements: RECOMMENDATIONS.

Keywords: cesarean sction; fetal growth restriction; premature birth; twins.