{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T23:12:42Z","timestamp":1767827562555,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T00:00:00Z","timestamp":1577059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In September 2019, NICE published updated guidance on the management of multiple pregnancy (NG 137). Many of the previous recommendations for care are upheld but there have been important changes: increased frequency of combined ultrasound\/specialist antenatal care appointments for pregnancies containing a monochorionic placenta (twins and triplets), increased frequency of ultrasound monitoring in all triplet pregnancies, changes in the definition of selective growth restriction and its subsequent referral pathways, the introduction of some monitoring for twin (or triplet) anemia polycythemia sequence in monochorionic pregnancies (albeit in complex pregnancies or at an advanced stage), and a recommended timing of birth for any pregnancy with monoamniotic fetuses. New recommendations have been made for mode of delivery, fetal monitoring in labor, maternal analgesia, and the prevention of postpartum hemorrhage. The absence of any recommendation relating to the prevention of preterm birth is notable. The basis and implications of the updates that may improve perinatal outcomes are discussed.<\/jats:p>","DOI":"10.1111\/aogs.13785","type":"journal-article","created":{"date-parts":[[2019,12,4]],"date-time":"2019-12-04T10:57:45Z","timestamp":1575457065000},"page":"147-152","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Updated guidance for the management of twin and triplet pregnancies from the National Institute for Health and Care Excellence guidance, UK: What's new that may improve perinatal outcomes?"],"prefix":"10.1111","volume":"99","author":[{"given":"Janice L.","family":"Gibson","sequence":"first","affiliation":[{"name":"Ian Donald Fetal Medicine Centre Queen Elizabeth University Hospital Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James S.","family":"Castleman","sequence":"additional","affiliation":[{"name":"West Midlands Fetal Medicine Centre Birmingham Women's and Children's NHS Foundation Trust Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shireen","family":"Meher","sequence":"additional","affiliation":[{"name":"West Midlands Fetal Medicine Centre Birmingham Women's and Children's NHS Foundation Trust Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9987-4223","authenticated-orcid":false,"given":"Mark D.","family":"Kilby","sequence":"additional","affiliation":[{"name":"West Midlands Fetal Medicine Centre Birmingham Women's and Children's NHS Foundation Trust Birmingham UK"},{"name":"Institute of Metabolism and Systems Research University of Birmingham Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119211457.ch21"},{"key":"e_1_2_6_3_1","volume-title":"Multiple Pregnancy","author":"Ward RH","year":"1995"},{"key":"e_1_2_6_4_1","volume-title":"Multiple Pregnancy Study\u2010Group Statement: Consensus Views Arising from the 50th Study Group","author":"Kilby MD","year":"2006"},{"key":"e_1_2_6_5_1","unstructured":"National Institute for Health and Care Excellence.Twin and triplet pregnancy.2019.https:\/\/www.nice.org.uk\/guidance\/ng137. Accessed October 10 2019."},{"key":"e_1_2_6_6_1","unstructured":"Royal College of Obstetricians and Gynaecologists Guidelines: Monochorionic twin pregnancy Management (Green Top Guideline No: 51). Guideline developers Professor MD Kilby and Dr L Bricker 2016.https:\/\/www.rcog.org.uk\/en\/guidelines-research-services\/guidelines\/gtg51\/. Accessed September 15 2019."},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15821"},{"key":"e_1_2_6_8_1","unstructured":"Multiple Pregnancy antenatal care for twin and triplet pregnancies. NICE Clinical Guideline CG 137cvvvvb update.2019.https:\/\/www.nice.org.uk\/guidance\/NG137. 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NICE Clinical Guideline CG 190.2014.https:\/\/www.nice.org.uk\/cg190\/history\/. Accessed September 15 2019."},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17397"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-026430"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15517"},{"key":"e_1_2_6_24_1","unstructured":"NICE Excellence (2\u201313).Multiple pregnancy: twin & triplet pregnancy.https:\/\/www.nice.org.uk\/guidance\/qs46\/resources\/multiple-pregnancy-twin-and-triplet-pregnancies-pdf-2098670068933. Accessed November 1 2018."},{"key":"e_1_2_6_25_1","unstructured":"Twin and Multiple Births Association Maternity Engagement Project Interim Report 2018.https:\/\/www.tamba.org.uk\/document.doc?xml:id=985. 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