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Perinatal Outcomes of Small for Gestational Age in Twin Pregnancies: Twin vs. Singleton Charts
Review

Review of International Clinical Guidelines Related to Prenatal Screening during Monochorionic Pregnancies

1
Department of Social Sciences, D’Youville College, 591 Niagara Street, Buffalo, NY 14201, USA
2
Department of Family and Community Medicine, Northeast Ohio Medical University, 4209 State Route 44, P.O. Box 95, Rootstown, OH 44272, USA
3
Twin Anemia Polycythemia Sequence (TAPS) Support Foundation, Founder, 1326HS Almere, The Netherlands
*
Author to whom correspondence should be addressed.
Academic Editor: Johannes Ott
J. Clin. Med. 2021, 10(5), 1128; https://doi.org/10.3390/jcm10051128
Received: 27 December 2020 / Revised: 11 February 2021 / Accepted: 1 March 2021 / Published: 8 March 2021
(This article belongs to the Special Issue Improving Perinatal Outcomes in Twin and Multiple Pregnancy)
We conducted a search for international clinical guidelines related to prenatal screening during monochorionic pregnancies. We found 25 resources from 13 countries/regions and extracted information related to general screening as well as screening related to specific monochorionic complications, including twin-twin transfusion syndrome (TTTS), selective fetal growth restriction (SFGR), and twin anemia-polycythemia sequence (TAPS). Findings reveal universal recommendation for the early establishment of chorionicity. Near-universal recommendation was found for bi-weekly ultrasounds beginning around gestational week 16; routine TTTS and SFGR surveillance comprised of regularly assessing fetal growth, amniotic fluids, and bladder visibility; and fetal anatomical scanning between gestational weeks 18–22. Conflicting recommendation was found for nuchal translucency screening; second-trimester scanning for cervical length; routine TAPS screening; and routine umbilical artery, umbilical vein, and ductus venosus assessment. We conclude that across international agencies and organizations, clinical guidelines related to monochorionic prenatal screening vary considerably. This discord raises concerns related to equitable access to evidence-based monochorionic prenatal care; the ability to create reliable international datasets to help improve the quality of monochorionic research; and the promotion of patient safety and best monochorionic outcomes. Patients globally may benefit from the coming together of international bodies to develop inclusive universal monochorionic prenatal screening standards. View Full-Text
Keywords: monochorionic twin pregnancy; screening; clinical guidelines monochorionic twin pregnancy; screening; clinical guidelines
MDPI and ACS Style

Nicholas, L.; Fischbein, R.; Ernst-Milner, S.; Wani, R. Review of International Clinical Guidelines Related to Prenatal Screening during Monochorionic Pregnancies. J. Clin. Med. 2021, 10, 1128. https://doi.org/10.3390/jcm10051128

AMA Style

Nicholas L, Fischbein R, Ernst-Milner S, Wani R. Review of International Clinical Guidelines Related to Prenatal Screening during Monochorionic Pregnancies. Journal of Clinical Medicine. 2021; 10(5):1128. https://doi.org/10.3390/jcm10051128

Chicago/Turabian Style

Nicholas, Lauren, Rebecca Fischbein, Stephanie Ernst-Milner, and Roshni Wani. 2021. "Review of International Clinical Guidelines Related to Prenatal Screening during Monochorionic Pregnancies" Journal of Clinical Medicine 10, no. 5: 1128. https://doi.org/10.3390/jcm10051128

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