Table 4 Prior studies of specialised twin pregnancy care
Sen et al., 2005 [20] | Ellings et al., 1993 [6] | Ruiz et al., 2001 [7] | Luke et al., 2003 [8] | |
|---|---|---|---|---|
Study design | RCT | Retrospective cohort – Twins Clinic and contemporaneous ANC patients | Retrospective historical cohort – Twins clinic and ANC pre Twins clinic | Retrospective cohort – multiple pregnancy clinic vs. contemporaneous ANC patients |
Number of women | 80 specialised care, 82 standard care | 89 TC, 51 ANC | 30 TC, 41 ANC | 190 TC, 339 ANC |
Chorionicity data | Not available | Not available | Not available | Only DCDA twins included |
Interventions studied | Midwifery-led antenatal and postnatal visits, patient education | Multidisciplinary MFM-led care, consistent protocols including dietary, evaluation of maternal symptoms and cervical status, patient education | Nurse practitioner care, standard protocols, weekly visits from 24 weeks, home visit for social assessment | Fortnightly visits, dietary supplementation and advice, patient education |
Significant Findings | Increased Caesarean Section rate | Decreased perinatal mortality (1 vs. 8 %), decreased incidence birthweight <1500 g (6 vs. 26 %), decreased NICU admission (13 vs. 38 %) | Decreased premature birth <30 weeks (0 vs. 29 %) and <36 weeks (32 vs. 41 %), decreased neonatal length of stay and cost | Multiple improved maternal and fetal outcomes including decreased preeclampsia, higher birthweight, lower serious neonatal morbidity rates, decreased cost/twin of care, less rehospitalisation or developmental delay to age 3 |
No significant change in other maternal or fetal outcomes | ||||
No difference maternal antenatal complications |