New guidance for multiple births provided by NICE

More scans and closer monitoring for mothers expecting twins or triplets have been recommended by the healthcare watchdog NICE. Suggested guidelines include a minimum of six scans, and referral to a specialist team to provide mothers with more reassurance.

Up until now there have been no clear guidelines for multiple births, leading to a wide variation in the care provided. Now multiple births are on the rise, mainly due to the increase in IVF.

Dr Fergus Macbeth, director of the centre for clinical practice at NICE, said: “We know there is a real clinical need for this guideline because NHS antenatal care for women expecting twins or triplets appears to vary considerably across England and Wales.

“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 Royal College of Midwives welcomed the new guidelines. 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.