{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T08:53:54Z","timestamp":1784364834847,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T00:00:00Z","timestamp":1719878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["128596"],"award-info":[{"award-number":["128596"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2024,11]]},"abstract":"Abstract<\/jats:title>Objective<\/jats:title>To identify current practices in the management of selective fetal growth restriction (sFGR) in monochorionic diamniotic (MCDA) twin pregnancies.<\/jats:p><\/jats:sec>Design<\/jats:title>Cross\u2010sectional survey.<\/jats:p><\/jats:sec>Setting<\/jats:title>International.<\/jats:p><\/jats:sec>Population<\/jats:title>Clinicians involved in the management of MCDA twin pregnancies with sFGR.<\/jats:p><\/jats:sec>Methods<\/jats:title>A structured, self\u2010administered survey.<\/jats:p><\/jats:sec>Main Outcome Measures<\/jats:title>Clinical practices and attitudes to diagnostic criteria and management strategies.<\/jats:p><\/jats:sec>Results<\/jats:title>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\u2010twin EFW discordance of >25% for the diagnosis of sFGR. For early\u2010onset type\u2009I sFGR, 79.8% (75\/94) of respondents expressed that expectant management would be their routine practice. On the other hand, for early\u2010onset type\u2009II and type\u2009III 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\u2009II and type\u2009III cases, respectively. Moreover, 39.0% (16\/41) of the respondents would consider fetoscopic laser surgery (FLS) for early\u2010onset type\u2009I 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\u2010onset type\u2009II and type\u2009III 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.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>There is significant variation in clinician practices and attitudes towards the management of early\u2010onset sFGR in MCDA twin pregnancies, especially for type\u2009II and type\u2009III cases, highlighting the need for high\u2010level evidence to guide management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17891","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T04:00:49Z","timestamp":1719979249000},"page":"1684-1693","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Diagnosis and management of selective fetal growth restriction in monochorionic twin pregnancies: A cross\u2010sectional international survey"],"prefix":"10.1111","volume":"131","author":[{"given":"Smriti","family":"Prasad","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, Department of Obstetrics and Gynaecology St George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma","family":"Khalil","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Department of Obstetrics and Gynaecology St George's University Hospitals NHS Foundation Trust London UK"},{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London London UK"},{"name":"Fetal Medicine Unit Liverpool Women's Hospital, University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie J.","family":"Kirkham","sequence":"additional","affiliation":[{"name":"Centre for Biostatistics The University of Manchester, Manchester Academic Health Science Centre 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