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Twin pregnancies are associated with an elevated risk of complications, including preterm birth, hypertensive disorders, gestational diabetes, cesarean delivery, and fetal growth restriction (Sibai BM, Hauth J, Caritis S, Lindheimer MD, MacPherson C, Klebanoff M, et al., Am J Obstet Gynecol 182(4):938–42, 2000; Hiersch L, Berger H, Okby R, Ray JG, Geary M, Mcdonald SD, et al., Arch Gynecol Obstet 298(3):579–87, 2018; Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP, Vital Stat Rep 73(2):1–56, 2024; Schmitz T, Prunet C, Azria E, Bohec C, Bongain A, Chabanier P, et al., Obstet Gynecol 129(6):986–995, 2017). Nonetheless, high-quality evidence regarding the management of twin pregnancies remains limited Grantz KL, Kawakita T, Lu YL, Newman R, Berghella V, Caughey A, Am J Obstet Gynecol 221(2):B2–12, 2019), presenting challenges for healthcare providers in identifying optimal strategies for twin care. In this chapter, we aim to synthesize and compare the recommendations from selected professional societies from different countries (the United States, the United Kingdom, Germany, Australia, France, Canada, New Zealand, FIGO, and ISOUG) (Obstet Gynecol 137(6):e145–e162, 2021; Lee HS, Abbasi N, Van Mieghem T, Mei-Dan E, Audibert F, Brown R, et al., J Obstet Gynaecol Can 45(8):587–606.e8, 2023; Kilby MD, Bricker L on behalf of the Royal College of Obstetricians and Gynaecologists, BJOG 124:e1–e45, 2016, Twin and triplet pregnancy: National Institute for Health and Care Excellence (NICE) guidelines, 2019; Royal Australian and New Zealand College of Obstetricians and Gynaecologists: Management of monochorionic twin pregnancy, 2021; Vayssière C, Benoist G, Blondel B, Deruelle P, Favre R, Gallot D, et al., Eur J Obstet Gynecol Reprod Biol 156(1):12–7, 2011; Von Kaisenberg C, Klaritsch P, Ochsenbein-Kölble N, Hodel ME, Nothacker M, Hecher K, Ultraschall Med – Eur J Ultrasound 42(04):367–78, 2021; Mei-Dan E, Jain V, Melamed N, Lim KI, Aviram A, Ryan G, et al., J Obstet Gynaecol Can 44(7):819–834.e1, 2022) concerning twin pregnancies, highlighting both similarities and controversies. Our focus will be on the screening and prevention of preterm birth, antenatal surveillance, twin complications, and the mode and timing of delivery.

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Comparative Analysis of International and National Guidelines for the Management of Twin Pregnancies

  • 章节

  • 发表日期：

    2026年

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  • Serena Lucarelli,
  • Viola Seravalli,
  • Mariarosaria Di Tommaso

摘要

Twin pregnancies are associated with an elevated risk of complications, including preterm birth, hypertensive disorders, gestational diabetes, cesarean delivery, and fetal growth restriction (Sibai BM, Hauth J, Caritis S, Lindheimer MD, MacPherson C, Klebanoff M, et al., Am J Obstet Gynecol 182(4):938–42, 2000; Hiersch L, Berger H, Okby R, Ray JG, Geary M, Mcdonald SD, et al., Arch Gynecol Obstet 298(3):579–87, 2018; Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP, Vital Stat Rep 73(2):1–56, 2024; Schmitz T, Prunet C, Azria E, Bohec C, Bongain A, Chabanier P, et al., Obstet Gynecol 129(6):986–995, 2017). Nonetheless, high-quality evidence regarding the management of twin pregnancies remains limited Grantz KL, Kawakita T, Lu YL, Newman R, Berghella V, Caughey A, Am J Obstet Gynecol 221(2):B2–12, 2019), presenting challenges for healthcare providers in identifying optimal strategies for twin care. In this chapter, we aim to synthesize and compare the recommendations from selected professional societies from different countries (the United States, the United Kingdom, Germany, Australia, France, Canada, New Zealand, FIGO, and ISOUG) (Obstet Gynecol 137(6):e145–e162, 2021; Lee HS, Abbasi N, Van Mieghem T, Mei-Dan E, Audibert F, Brown R, et al., J Obstet Gynaecol Can 45(8):587–606.e8, 2023; Kilby MD, Bricker L on behalf of the Royal College of Obstetricians and Gynaecologists, BJOG 124:e1–e45, 2016, Twin and triplet pregnancy: National Institute for Health and Care Excellence (NICE) guidelines, 2019; Royal Australian and New Zealand College of Obstetricians and Gynaecologists: Management of monochorionic twin pregnancy, 2021; Vayssière C, Benoist G, Blondel B, Deruelle P, Favre R, Gallot D, et al., Eur J Obstet Gynecol Reprod Biol 156(1):12–7, 2011; Von Kaisenberg C, Klaritsch P, Ochsenbein-Kölble N, Hodel ME, Nothacker M, Hecher K, Ultraschall Med – Eur J Ultrasound 42(04):367–78, 2021; Mei-Dan E, Jain V, Melamed N, Lim KI, Aviram A, Ryan G, et al., J Obstet Gynaecol Can 44(7):819–834.e1, 2022) concerning twin pregnancies, highlighting both similarities and controversies. Our focus will be on the screening and prevention of preterm birth, antenatal surveillance, twin complications, and the mode and timing of delivery.