Evidence mapPaperPMID 37179347Full record

SynthesisBMC pregnancy and childbirth2023

Clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancies: a systematic review.

Caroline O'Connor, Emily O'Connor, Sara Leitao, Shauna Barrett, Keelin O'Donoghue

Abstract readSystematic Review
In one paragraph

Synthesis in BMC pregnancy and childbirth, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Caroline O'ConnorINFANT Research Centre, University College Cork, Cork, Ireland. carolineoconnor@ucc.ie.ORCID http://orcid.org/0000-0002-1691-8313
Emily O'ConnorINFANT Research Centre, University College Cork, Cork, Ireland.
Sara LeitaoPregnancy Loss Research Group, Department of Obstetrics & Gynecology, University College Cork, Cork, Ireland.
Shauna BarrettCork University Hospital Library, Cork University Hospital, Cork, Ireland.
Keelin O'DonoghueINFANT Research Centre, University College Cork, Cork, Ireland.

Funding

Irish Research Council GOIPG/2020/928
6 · The paper itself

Abstract

objectiveThis review aimed to identify guidelines with recommendations applicable to the antenatal management of dichorionic diamniotic twin pregnancies within high-income countries, appraise their methodological quality, and discuss the similarities and variability across guidelines.

methodA systematic literature review of electronic databases was performed. Manual searches of guideline repositories and websites of professional organisations were performed to identify additional guidelines. The protocol for this systematic review was registered on PROSPERO (CRD42021248586, 25 June 2021). AGREE II and AGREE-REX tools were applied to assess the quality of eligible guidelines. A narrative and thematic synthesis described and compared the guidelines and their recommendations.

resultsTwenty-four guidelines were included, from which 483 recommendations were identified across 4 international organisations and 12 countries. Guidelines addressed eight themes and recommendations were classified accordingly: chorionicity and dating (103 recommendations), fetal growth (105 recommendations), termination of pregnancy (12 recommendations), fetal death (13 recommendations), fetal anomalies (65 recommendations), antenatal care (65 recommendations), preterm labour (56 recommendations) and birth (54 recommendations). Guidelines showed significant variability in recommendations, with conflicting recommendations regarding non-invasive preterm testing, definitions surrounding selective fetal growth restriction, screening for preterm labour and the timing of birth. Guidelines lacked a focus on standard antenatal management of DCDA twins, management of discordant fetal anomaly and single fetal demise.

conclusionsSpecific guidance for dichorionic diamniotic twins is overall indistinct and access to guidance regarding the antenatal management of these pregnancies is currently difficult. Management of discordant fetal anomaly or single fetal demise needs greater consideration.

Indexed as

Obstetric Labor, PrematurePregnancy, TwinFemaleFetal DeathHumansInfant, NewbornPregnancyPregnancy OutcomeRetrospective StudiesTwins, DizygoticAntenatal managementClinical practice guidelinesDichorionic diamnioticTwin pregnancy

Identifiers

PMID37179347
PMCPMC10182673

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.