NICE has issued an updated quality standard focusing on supplementary antenatal care for pregnant women expecting twins or triplets, along with routine antenatal care.
The key goals of the quality standard are improvements in the following areas:
- Infant mortality rates
- Rates of neonatal mortality and stillbirths
- Women's experience of maternity services
- Neonatal care for full-term babies
The updated quality standard covers the following eight recommendations:
- Women with a multiple pregnancy should undergo the determination of the chorionicity and amnionicity of their pregnancy through ultrasonography between 11 weeks 0 days and 13 weeks 6 days.
- Women should have their foetuses labelled through ultrasonography between 11 weeks 0 days and 13 weeks 6 days.
- A multidisciplinary core team should provide care for women with a multiple pregnancy.
- Women with a multiple pregnancy should receive a care plan specifying the timing of appointments with the multidisciplinary core team based on the chorionicity and amnionicity of pregnancy.
- Foetal complications should be monitored based on the chorionicity and amnionicity of pregnancy.
- If the multiple pregnancy carries a high risk or is complicated, care should be provided by a consultant from a tertiary level foetal medicine centre.
- The multidisciplinary core team should brief the women regarding the risks, signs and symptoms of preterm labour and possible outcomes of preterm birth by 24 weeks of gestation.
- The multidisciplinary core team should have a discussion regarding the timing of birth and possible modes of delivery with the women by 28 weeks, so as to agree upon a birth plan.