Twin pregnancies: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF)

Vayssière, Christophe; Benoist, G.; Blondel, Béatrice; Deruelle, Philippe; Favre, R.; Gallot, Denis; Jabert, Paul; Lémery, D.; Picone, Olivier; Pons, Jean-Claude; Puech, F; Quarello, E.; Salomon, Laurent; Schmitz, Thomas; Sénat, Marie-Victoire; Sentilhes, Loïc; Simon, Agnès; Stirneman, J.; Vendittelli, Françoise; Winer, Norbert; Ville, Y.

doi:10.1016/j.ejogrb.2010.12.045

Cited by 170 publications

(152 citation statements)

References 3 publications

Supporting

Mentioning

144

Contrasting

Unclassified

Order By: Relevance

“…5,38 When twin pregnancies are identified, the mothers should receive antenatal care that, given the often resource poor environments they live in, is as much as possible in line with existing guidelines for twin pregnancies. 18,19,36 Second, it is important that delivery should take place in a hospital setting with staff trained in twin deliveries and with facilities for interventions, including caesarean section. 5,35 Twins are a high-risk group, associated with preterm delivery and complications such as post-partum haemorrhage and increased maternal mortality.…”

Section: Discussionmentioning

confidence: 99%

“…2,4 Although effective guidelines are available for antenatal and delivery care for twins, 18,19 many women in the region receive little antenatal care at all and deliver in a nonmedical setting. 5,17 Given the high absolute number of twin births in sub-Saharan Africa, in combination with the high perinatal and maternal mortality surrounding these births, it might be difficult, without special attention to this vulnerable group, to achieve the Every Newborn 2035 target of fewer than ten neonatal deaths per 1000 livebirths 20 26 twins are not mentioned.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries

Monden

Smits

2017

The Lancet Global Health

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries

Monden

Smits

2017

The Lancet Global Health

View full text Add to dashboard Cite

show abstract

“…Current recommendations vary on the timing of delivery, starting from 34 up to 37 weeks’ gestation in monochorionic twin pregnancies8 and from 37 up to 39 weeks in dichorionic twin pregnancies 910 11 12 Women and their partners, clinicians, and guideline makers need robust estimates of the risk of stillbirth from continuing the pregnancy and the neonatal risk from early delivery to decide on the optimal timing of delivery. Existing reviews have focused mainly on the risk of stillbirth, without taking neonatal outcomes into account 13.…”

Section: Introductionmentioning

confidence: 99%

Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis

Cheong-See

Schuit

Arroyo-Manzano

et al. 2016

BMJ

188

150

View full text Add to dashboard Cite

Objective To determine the risks of stillbirth and neonatal complications by gestational age in uncomplicated monochorionic and dichorionic twin pregnancies.Design Systematic review and meta-analysis.Data sources Medline, Embase, and Cochrane databases (until December 2015). Review methods Databases were searched without language restrictions for studies of women with uncomplicated twin pregnancies that reported rates of stillbirth and neonatal outcomes at various gestational ages. Pregnancies with unclear chorionicity, monoamnionicity, and twin to twin transfusion syndrome were excluded. Meta-analyses of observational studies and cohorts nested within randomised studies were undertaken. Prospective risk of stillbirth was computed for each study at a given week of gestation and compared with the risk of neonatal death among deliveries in the same week. Gestational age specific differences in risk were estimated for stillbirths and neonatal deaths in monochorionic and dichorionic twin pregnancies after 34 weeks’ gestation.Results 32 studies (29 685 dichorionic, 5486 monochorionic pregnancies) were included. In dichorionic twin pregnancies beyond 34 weeks (15 studies, 17 830 pregnancies), the prospective weekly risk of stillbirths from expectant management and the risk of neonatal death from delivery were balanced at 37 weeks’ gestation (risk difference 1.2/1000, 95% confidence interval −1.3 to 3.6; I2=0%). Delay in delivery by a week (to 38 weeks) led to an additional 8.8 perinatal deaths per 1000 pregnancies (95% confidence interval 3.6 to 14.0/1000; I2=0%) compared with the previous week. In monochorionic pregnancies beyond 34 weeks (13 studies, 2149 pregnancies), there was a trend towards an increase in stillbirths compared with neonatal deaths after 36 weeks, with an additional 2.5 per 1000 perinatal deaths, which was not significant (−12.4 to 17.4/1000; I2=0%). The rates of neonatal morbidity showed a consistent reduction with increasing gestational age in monochorionic and dichorionic pregnancies, and admission to the neonatal intensive care unit was the commonest neonatal complication. The actual risk of stillbirth near term might be higher than reported estimates because of the policy of planned delivery in twin pregnancies.Conclusions To minimise perinatal deaths, in uncomplicated dichorionic twin pregnancies delivery should be considered at 37 weeks’ gestation; in monochorionic pregnancies delivery should be considered at 36 weeks.Systematic review registration PROSPERO CRD42014007538.

show abstract

“…This insertion zone has an aspect of lamda sign in dichorionic pregnancy, corresponding to the extension of placental tissue into the base of inter-twin membrane 3 . In monochorionic pregnancy, this zone has an aspect of T sign.…”

mentioning

confidence: 99%

Pitfall in first-trimester diagnosis of chorionicity in twin pregnancy

Gueneuc

Spaggiari

Bonnière

et al. 2017

Ultrasound Obstet Gynecol

View full text Add to dashboard Cite

Twin pregnancies: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF)

Cited by 170 publications

References 3 publications

Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries

Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries

Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis

Pitfall in first-trimester diagnosis of chorionicity in twin pregnancy

Contact Info

Product

Resources

About