Multidisciplinary consensus on screening for, diagnosis and management of fetal growth restriction in the Netherlands

BMC Pregnancy and Childbirth

Research Article

Lidwine Mokkink¹  Henriëtte van der Horst²  Arie Franx³  Myrte Westerneng⁴  Petra Jellema⁴  Ank de Jonge⁴  Viki Verfaille⁴ 

[1] Department of Epidemiology and Biostatistics and Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081, Amsterdam, BT, the Netherlands;Department of General Practice, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081, Amsterdam, BT, the Netherlands;Department of Gynecology, Utrecht University Medical Centre, Heidelberglaan 100, 3584, Utrecht, CX, the Netherlands;Midwifery Science, AVAG, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081, Amsterdam, BT, the Netherlands;

关键词: Intrauterine growth restriction;    fetal growth restriction;    Delphi technique;    Practice guideline;    Prenatal ultrasonography;    Collaboration;    Uniform approach;   

DOI  :  10.1186/s12884-017-1513-3

 received in 2016-07-11, accepted in 2017-09-15,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundScreening for, diagnosis and management of intrauterine growth restriction (IUGR) is often performed in multidisciplinary collaboration. However, variation in screening methods, diagnosis and management of IUGR may lead to confusion. In the Netherlands two monodisciplinary guidelines on IUGR do not fully align. To facilitate effective collaboration between different professionals in perinatal care, we undertook a Delphi study with uniform recommendations as our primary result, focusing on issues that are not aligned or for which specifications are lacking in the current guidelines.MethodsWe conducted a Delphi study in three rounds. A purposively sampled selection of 56 panellists participated: 27 representing midwife-led care and 29 obstetrician-led care. Consensus was defined as agreement between the professional groups on the same answer and among at least 70% of the panellists within groups.ResultsPer round 51 or 52 (91% - 93%) panellists responded. This has led to consensus on 27 issues, leading to four consensus based recommendations on screening for IUGR in midwife-led care and eight consensus based recommendations on diagnosis and eight on management in obstetrician-led care. The multidisciplinary project group decided on four additional recommendations as no consensus was reached by the panel. No recommendations could be made about induction of labour versus expectant monitoring, nor about the choice for a primary caesarean section.ConclusionsWe reached consensus on recommendations for care for IUGR within a multidisciplinary panel. These will be implemented in a study on the effectiveness and cost-effectiveness of routine third trimester ultrasound for monitoring fetal growth. Research is needed to evaluate the effects of implementation of these recommendations on perinatal outcomes.Trial registrationNTR4367.

【 授权许可】

CC BY   
© The Author(s). 2017