The NICE recommendations say women with a multiple pregnancy should
receive specialist care from an experienced multidisciplinary team.
It
is hoped this will result in a drop in the number of assisted births
and caesarean sections and will save the cash-strapped NHS money.
The guidelines are the first NICE has published on how to improve antenatal services for women pregnant with twins or triplets.
Dr
Fergus Macbeth, director of the centre for clinical practice at NICE,
said there is a ‘real clinical need’ for the guidance, as antenatal care
for women expecting twins or triplets ‘varies considerably’ across
England and Wales.
He continued:
‘For example, not all women with multiple pregnancies are cared for in
dedicated settings such as twin clinics or by multidisciplinary teams of
healthcare professionals.
‘This
can lead to higher than necessary rates of assisted birth and caesarean
sections and also means that women are not appropriately assessed for
possible risks during pregnancy.
‘Although
many women will have a normal pregnancy and birth, it is well known
that there are higher risks involved for these types of pregnancy and so
it is important to get it right. ‘
The recommendations come after a rise in the number of multiple births over the last three decades.
They
now account for 3% of all live births, after an increase believed to be
due to the introduction of IVF and other assisted reproduction
techniques.
The guidelines
recommend that a specialist team, with previous experience of caring for
women with multiple pregnancies, should provide care for women with
uncomplicated twin and triplet pregnancies.
The
team should be made up of obstetricians, midwives and
ultrasonographers, and should also offer women information and emotional
support.
The recommendations
also includes a table outlining the frequency and timing of antenatal
care visits for women with multiple pregnancies, including tasks to be
carried out at each visit and additional risk factors to monitor.
Jane
Munro, the RCM’s quality and audit development advisor, said: ‘We
welcome the publication of this important guideline and are pleased to
see the recommendation that clinical care for women with twin and
triplet pregnancies should be provided by a specialist multidisciplinary
team.
‘We know that women will
value access to the appropriate information and emotional support
unique to multiple pregnancies at their first meeting with a midwife and
the maternity services.
‘The
guidance’s focus on coordinating clinical care will allow the minimum
number of hospital visits and care as close to a woman’s home, as
possible.’
To see the full guidelines,
click here.
