%0 Journal Article
%T Diagnosis and management of selective fetal growth restriction in monochorionic twin pregnancies: A cross-sectional international survey.
%A Prasad S
%A Khalil A
%A Kirkham JJ
%A Sharp A
%A Woolfall K
%A Mitchell TK
%A Yaghi O
%A Ricketts T
%A Popa M
%A Alfirevic Z
%A Anumba D
%A Ashcroft R
%A Attilakos G
%A Bailie C
%A Baschat AA
%A Cornforth C
%A Costa FDS
%A Denbow M
%A Deprest J
%A Fenwick N
%A Haak MC
%A Hardman L
%A Harrold J
%A Healey A
%A Hecher K
%A Parasuraman R
%A Impey L
%A Jackson R
%A Johnstone E
%A Leven S
%A Lewi L
%A Lopriore E
%A Oconnor I
%A Harding D
%A Marsden J
%A Mendoza J
%A Mousa T
%A Nanda S
%A Papageorghiou AT
%A Pasupathy D
%A Sandall J
%A Thangaratinam S
%A Thilaganathan B
%A Turner M
%A Vollmer B
%A Watson M
%A Wilding K
%A Yinon Y
%A  
%J BJOG
%V 0
%N 0
%D 2024 Jul 2
%M 38956742
%F 7.331
%R 10.1111/1471-0528.17891
%X <B>OBJECTIVE: </B>To identify current practices in the management of selective fetal growth restriction (sFGR) in monochorionic diamniotic (MCDA) twin pregnancies.<BR><B>METHODS: </B>Cross-sectional survey.<BR><B>METHODS: </B>International.<BR><B>METHODS: </B>Clinicians involved in the management of MCDA twin pregnancies with sFGR.<BR><B>METHODS: </B>A structured, self-administered survey.<BR><B>METHODS: </B>Clinical practices and attitudes to diagnostic criteria and management strategies.<BR><B>RESULTS: </B>Overall, 62.8% (113/180) of clinicians completed the survey; of which, 66.4% (75/113) of the respondents reported that they would use an estimated fetal weight (EFW) of <10th centile for the smaller twin and an inter-twin EFW discordance of >25% for the diagnosis of sFGR. For early-onset type I sFGR, 79.8% (75/94) of respondents expressed that expectant management would be their routine practice. On the other hand, for early-onset type II and type III sFGR, 19.3% (17/88) and 35.7% (30/84) of respondents would manage these pregnancies expectantly, whereas 71.6% (63/88) and 57.1% (48/84) would refer these pregnancies to a fetal intervention centre or would offer fetal intervention for type II and type III cases, respectively. Moreover, 39.0% (16/41) of the respondents would consider fetoscopic laser surgery (FLS) for early-onset type I sFGR, whereas 41.5% (17/41) would offer either FLS or selective feticide, and 12.2% (5/41) would exclusively offer selective feticide. For early-onset type II and type III sFGR cases, 25.9% (21/81) and 31.4% (22/70) would exclusively offer FLS, respectively, whereas 33.3% (27/81) and 32.9% (23/70) would exclusively offer selective feticide.<BR><B>CONCLUSIONS: </B>There is significant variation in clinician practices and attitudes towards the management of early-onset sFGR in MCDA twin pregnancies, especially for type II and type III cases, highlighting the need for high-level evidence to guide management.