该指南回顾了正常和复杂的单绒毛膜双胎妊娠的循证管理。
单绒毛膜双胎或更高阶多胎妊娠的妇女。
实施这些建议应改善复杂和不复杂的单绒毛膜(和高阶多胎)双胎妊娠的管理。他们将帮助用户适当监测单绒毛膜双胎妊娠,并及时最佳地识别和管理单绒毛膜双胎并发症,从而降低围产期发病率和死亡率。与双绒毛膜双胞胎相比,这些建议需要对单绒毛膜双胞胎进行更频繁的超声监测。
通过使用适当的MeSH标题(Twins,单卵型;超声检查,产前;胎盘;胎儿输血;胎儿死亡;胎儿生长迟缓)。结果仅限于系统评价,随机对照临床试验,和观察性研究。没有日期限制,但结果仅限于英语或法语材料。
内容和建议由主要作者起草并达成一致。SOGC理事会批准了最终草案以供出版。作者使用“建议分级评估”对证据质量和建议强度进行了评估,开发和评估(等级)方法。见在线附录A(表A1的定义和A2的强和条件[弱]建议的解释)。
母胎医学专家,产科医生,放射科医生,超声波检查者,家庭医生,护士,助产士,居民,和其他医疗保健提供者照顾单绒毛膜双胎或更高阶多胎妊娠的妇女。
加拿大(SOGC)诊断指南,单绒毛膜双胎妊娠并发症的超声监测和管理,包括TTTS,TAPS,sFGR(sIUGR),无心(TRAP),单羊膜双胞胎和一个MC双胞胎的子宫内死亡。
建议。
This
guideline reviews the evidence-based management of normal and complicated monochorionic twin pregnancies.
Women with monochorionic twin or higher order multiple pregnancies.
Implementation of these recommendations should improve the management of both complicated and uncomplicated monochorionic (and higher order multiple) twin pregnancies. They will help users monitor monochorionic twin pregnancies appropriately and identify and manage monochorionic twin complications optimally in a timely manner, thereby reducing perinatal morbidity and mortality. These recommendations entail more frequent ultrasound monitoring of monochorionic twins compared to dichorionic twins.
Published literature was retrieved through searches of PubMed and the Cochrane Library using appropriate MeSH headings (Twins, Monozygotic; Ultrasonography, Prenatal; Placenta; Fetofetal Transfusion; Fetal Death; Fetal Growth Retardation). Results were restricted to systematic reviews, randomized controlled clinical trials, and observational studies. There were no date limits, but results were limited to English or French language materials.
The content and recommendations were drafted and agreed upon by the principal authors. The Board of the SOGC approved the final draft for publication. The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional [weak] recommendations).
Maternal-fetal medicine specialists, obstetricians, radiologists, sonographers, family physicians, nurses, midwives, residents, and other health care providers who care for women with monochorionic twin or higher order multiple pregnancies.
Canadian (SOGC)
guidelines for the diagnosis, ultrasound surveillance and management of monochorionic twin pregnancy complications, including TTTS, TAPS, sFGR (sIUGR), acardiac (TRAP), monoamniotic twins and intrauterine death of one MC twin.
RECOMMENDATIONS.