Bibliographic Details
| Title: |
Management of the smaller twin with impending compromise in twin pregnancies complicated by selective fetal growth restriction: a questionnaire-based study of clinical practice patterns |
| Authors: |
So-hee Kim, Young Mi Jung, Chan-Wook Park, Joong Shin Park, Jong Kwan Jun, Mi Hye Park, Han Sung Hwang, Seung Mi Lee |
| Source: |
BMC Pregnancy and Childbirth, Vol 23, Iss 1, Pp 1-9 (2023) |
| Publisher Information: |
BMC, 2023. |
| Publication Year: |
2023 |
| Collection: |
LCC:Gynecology and obstetrics |
| Subject Terms: |
Multifetal pregnancy, Selective fetal growth restriction, Viability, Intact survival, Timing of delivery, Gynecology and obstetrics, RG1-991 |
| More Details: |
Abstract Background In twin pregnancies complicated by selective fetal growth restriction (sFGR), if the smaller twin is in the state of impending intra-uterine death (IUD), immediate delivery will reduce the risk of IUD of the smaller twin while exposing the larger twin to iatrogenic preterm birth (PTB). Therefore, the management options would either be to maintain pregnancy for the maturation of the larger twin despite the risk of IUD of the smaller twin or immediate delivery to prevent IUD of the smaller twin. However, the optimal gestational age of management transition from maintaining pregnancy to immediate delivery has not been established. The objective of this study was to evaluate the physician’s perspective on the optimal timing of immediate delivery in twin pregnancies complicated by sFGR. Methods An online cross-sectional survey was performed with obstetricians and gynecologists (OBGYN) in South Korea. The questionnaire asked the following: (1) whether participants would maintain or immediately deliver a twin pregnancy complicated by sFGR with signs of impending IUD of the smaller twin; (2) the optimal gestational age of management transition from maintaining pregnancy to immediate delivery in a twin pregnancy with impending IUD of the smaller twin; and (3) the limit of viability and intact survival in general preterm neonates. Results A total of 156 OBGYN answered the questionnaires. In a clinical scenario of dichorionic (DC) twin pregnancy complicated by sFGR with signs of impending IUD of the smaller twin, 57.1% of the participants answered that they would immediately deliver the twin pregnancy. However, 90.4% answered that they would immediately deliver the pregnancy in the same scenario for monochorionic (MC) twin pregnancy. The participants designated 30 weeks for DC twin and 28 weeks for MC twin pregnancies as the optimal gestational age of management transition from maintaining pregnancy to immediate delivery. The participants regarded 24 weeks as the limit of viability and 30 weeks as the limit of intact survival in general preterm neonates. The optimal gestational age of management transition for DC twin pregnancy was correlated with the limit of intact survival in general preterm neonates (p |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1471-2393 |
| Relation: |
https://doaj.org/toc/1471-2393 |
| DOI: |
10.1186/s12884-023-05616-3 |
| Access URL: |
https://doaj.org/article/f272b678e0e244b0b77d40bcfb399fa6 |
| Accession Number: |
edsdoj.f272b678e0e244b0b77d40bcfb399fa6 |
| Database: |
Directory of Open Access Journals |
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