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Abstract：
BACKGROUND: Screening for, diagnosis and management of intrauterine growth restriction (IUGR) is often performed in multidisciplinary collaboration. However, variation in screening methods, diagnosis and management of IUGR may lead to confusion. In the Netherlands two monodisciplinary guidelines on IUGR do not fully align. To facilitate effective collaboration between different professionals in perinatal care, we undertook a Delphi study with uniform recommendations as our primary result, focusing on issues that are not aligned or for which specifications are lacking in the current guidelines.
METHODS: We conducted a Delphi study in three rounds. A purposively sampled selection of 56 panellists participated: 27 representing midwife-led care and 29 obstetrician-led care. Consensus was defined as agreement between the professional groups on the same answer and among at least 70% of the panellists within groups.
RESULTS: Per round 51 or 52 (91% - 93%) panellists responded. This has led to consensus on 27 issues, leading to four consensus based recommendations on screening for IUGR in midwife-led care and eight consensus based recommendations on diagnosis and eight on management in obstetrician-led care. The multidisciplinary project group decided on four additional recommendations as no consensus was reached by the panel. No recommendations could be made about induction of labour versus expectant monitoring, nor about the choice for a primary caesarean section.
CONCLUSIONS: We reached consensus on recommendations for care for IUGR within a multidisciplinary panel. These will be implemented in a study on the effectiveness and cost-effectiveness of routine third trimester ultrasound for monitoring fetal growth. Research is needed to evaluate the effects of implementation of these recommendations on perinatal outcomes.
BACKGROUND: NTR4367 .
METHODS: We conducted a Delphi study in three rounds. A purposively sampled selection of 56 panellists participated: 27 representing midwife-led care and 29 obstetrician-led care. Consensus was defined as agreement between the professional groups on the same answer and among at least 70% of the panellists within groups.
RESULTS: Per round 51 or 52 (91% - 93%) panellists responded. This has led to consensus on 27 issues, leading to four consensus based recommendations on screening for IUGR in midwife-led care and eight consensus based recommendations on diagnosis and eight on management in obstetrician-led care. The multidisciplinary project group decided on four additional recommendations as no consensus was reached by the panel. No recommendations could be made about induction of labour versus expectant monitoring, nor about the choice for a primary caesarean section.
CONCLUSIONS: We reached consensus on recommendations for care for IUGR within a multidisciplinary panel. These will be implemented in a study on the effectiveness and cost-effectiveness of routine third trimester ultrasound for monitoring fetal growth. Research is needed to evaluate the effects of implementation of these recommendations on perinatal outcomes.
BACKGROUND: NTR4367 .
摘要：
背景：筛选，宫内生长受限（IUGR）的诊断和治疗通常在多学科合作中进行。然而,筛选方法的变化，IUGR的诊断和管理可能会导致混淆。在荷兰，关于IUGR的两项单学科准则并不完全一致。为了促进围产期护理不同专业人员之间的有效合作，我们进行了Delphi研究，以统一的建议作为我们的主要结果，重点关注当前指南中不一致或缺乏规范的问题。
方法：我们分三轮进行了Delphi研究。有目的地抽样选择了56名小组成员：27名代表助产士主导的护理和29名产科医生主导的护理。共识被定义为专业团体之间就相同答案达成一致，小组内至少70%的小组成员之间达成一致。
结果：每轮51或52（91％-93％）小组成员做出回应。在27个问题上达成了共识,导致在助产士主导的护理中,关于IUGR筛查的4项基于共识的建议,以及关于诊断的8项基于共识的建议和关于产科医生主导的护理管理的8项建议.多学科项目小组决定了另外四项建议，因为小组没有达成共识。没有关于引产和预期监测的建议，也没有选择一次剖腹产。
结论：我们在多学科小组内就IUGR的护理建议达成共识。这些将在一项关于常规妊娠晚期超声监测胎儿生长的有效性和成本效益的研究中实施。需要进行研究以评估实施这些建议对围产期结局的影响。
背景：NTR4367。
方法：我们分三轮进行了Delphi研究。有目的地抽样选择了56名小组成员：27名代表助产士主导的护理和29名产科医生主导的护理。共识被定义为专业团体之间就相同答案达成一致，小组内至少70%的小组成员之间达成一致。
结果：每轮51或52（91％-93％）小组成员做出回应。在27个问题上达成了共识,导致在助产士主导的护理中,关于IUGR筛查的4项基于共识的建议,以及关于诊断的8项基于共识的建议和关于产科医生主导的护理管理的8项建议.多学科项目小组决定了另外四项建议，因为小组没有达成共识。没有关于引产和预期监测的建议，也没有选择一次剖腹产。
结论：我们在多学科小组内就IUGR的护理建议达成共识。这些将在一项关于常规妊娠晚期超声监测胎儿生长的有效性和成本效益的研究中实施。需要进行研究以评估实施这些建议对围产期结局的影响。
背景：NTR4367。
