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Directive clinique no 428 : Prise en charge de la grossesse gémellaire bichoriale

      Résumé

      Objectif

      Examiner les recommandations fondées sur des données probantes pour la prise en charge de la grossesse gémellaire bichoriale.

      Population cible

      Femmes enceintes qui mènent une grossesse gémellaire bichoriale.

      Bénéfices, risques et coûts

      La mise en œuvre des recommandations de la présente directive pourrait améliorer la prise en charge de la grossesse gémellaire et réduire les risques de morbidité et mortalité néonatales et maternelles.

      Données probantes

      La littérature publiée a été rassemblée par des recherches dans les bases de données PubMed et Cochrane Library au moyen d’un vocabulaire contrôlé approprié (p. ex., twin, preterm birth). Seuls les résultats de revues systématiques, d’essais cliniques randomisés ou comparatifs et d’études observationnelles ont été retenus. Aucune contrainte n’a été appliquée quant à la date de publication, mais les résultats ont été limités aux contenus en anglais ou en français.

      Méthodes de validation

      Le contenu et les recommandations ont été rédigés et acceptés par les auteurs principaux. Le conseil d’administration de la SOGC a approuvé la version définitive aux fins de publication. Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant le cadre méthodologique d’évaluation, de développement et d’évaluation (GRADE). Consulter l’annexe A en ligne (le tableau A1 pour les définitions et le tableau A2 pour les interprétations des recommandations fortes et faibles).

      Professionnels concernés

      Obstétriciens, médecins de famille, infirmières, sages-femmes, spécialistes en médecine fœto-maternelle, radiologistes et autres professionnels de la santé qui prodiguent des soins aux femmes enceintes de jumeaux.

      DÉCLARATIONS SOMMAIRES

      • 1.
        Bien que les données actuelles laissent entendre que la taille du plus petit jumeau serait un indicateur plus précis de l’âge gestationnel au premier trimestre, d’autres études sont nécessaires pour parvenir à un consensus et justifier un changement aux pratiques. Par conséquent, il y a lieu de maintenir la pratique actuelle de la mesure du plus grand jumeau pour déterminer l’âge gestationnel (moyenne).
      • 2.
        La progestérone peut réduire le risque d’accouchement prématuré en cas de grossesse gémellaire avec col court (moyenne).
      • 3.
        Les données sont insuffisantes pour recommander l’utilisation d’un pessaire cervical en cas de grossesse gémellaire avec col court (moyenne).
      • 4.
        Le processus de consentement éclairé sur le mode d’accouchement gémellaire doit comprendre une discussion sur l’accouchement vaginal, la césarienne et l’accouchement combiné (élevée).
      • 5.
        L’accouchement vaginal planifié n’est pas plus risqué que la césarienne planifiée (élevée).
      • 6.
        La version podalique interne suivie de l’extraction par le siège est associée à une diminution de l’intervalle de naissance entre les jumeaux et peut réduire le risque d’accouchement combiné (faible).
      • 7.
        Les données probantes sur la grossesse gémellaire bichoriale sont insuffisantes pour recommander l’accouchement vaginal ou la césarienne comme l’option la plus sécuritaire en contexte de grande prématurité (poids fœtal estimé < 1 500 g) (faible).
      • 8.
        Les données probantes sur la grossesse gémellaire bichoriale sont insuffisantes pour recommander l’accouchement vaginal ou la césarienne comme option la plus sécuritaire en présence d’une discordance de croissance significative (> 25 %) (faible).
      • 9.
        En cas de grossesse gémellaire chez une femme avec antécédent de césarienne, l’épreuve de travail après césarienne est une solution de rechange sécuritaire à la césarienne itérative planifiée (faible).

      RECOMMANDATIONS

      • 1.
        Il faut déterminer la chorionicité avec précision et l’inscrire au dossier à l’évaluation échographique de chaque grossesse gémellaire, de préférence entre 11+0 et 13+6 semaines d’aménorrhée (forte, élevée).
      • 2.
        En cas de grossesse gémellaire conçue par fécondation in vitro, il faut utiliser la date de conception pour déterminer l’âge gestationnel (forte, moyenne).
      • 3.
        En cas de datation échographique d’une grossesse gémellaire par biométrie fœtale au deuxième trimestre, l’estimation biométrique la plus grande doit être utilisée (conditionnelle, moyenne).
      • 4.
        Il est recommandé d’identifier les jumeaux en fonction de leur orientation latérale ou verticale au lieu de leur proximité par rapport au col de l’utérus. Chez les jumeaux orientés latéralement, le jumeau A est celui se trouvant du côté droit maternel. L’identification des jumeaux doit être faite à la première évaluation échographique, en incluant d’autres caractéristiques échographiques distinctives qui peuvent en améliorer la précision. L’identification des jumeaux doit être maintenue pour toutes les échographies subséquentes (forte, moyenne).
      • 5.
        En cas de grossesse gémellaire bichoriale non compliquée, il faut surveiller la croissance fœtale toutes les 3 à 4 semaines à compter d’environ 24 semaines d’aménorrhée (conditionnelle, faible).
      • 6.
        Lorsqu’on utilise la biométrie échographique pour évaluer la vitesse de croissance, il y a lieu d’utiliser des courbes de croissance spécifiques aux jumeaux (forte, moyenne).
      • 7.
        En cas de grossesse gémellaire, il faut mesurer la longueur du col (idéalement par voie endovaginale) à l’échographie morphologique et, si possible, de nouveau avant 24 semaines d’aménorrhée, car la longueur du col est un bon indicateur du risque d’accouchement prématuré (forte, moyenne).
      • 8.
        L’alitement et la limitation de l’activité sont déconseillés pour la grossesse gémellaire avec ou sans facteurs de risque de l’accouchement prématuré (forte, moyenne).
      • 9.
        En cas de grossesse gémellaire, le cerclage du col doit être envisagé chez les femmes asymptomatiques dont la longueur du col est de 15 mm ou moins (conditionnelle, moyenne) et est recommandé en présence d’un col dilaté à 1 cm ou plus avant 24 semaines d’aménorrhée (forte, moyenne).
      • 10.
        En cas de grossesse gémellaire bichoriale non compliquée, il y a lieu d’offrir l’accouchement planifié à 37 à 38 semaines d’aménorrhée (forte, moyenne).
      • 11.
        Si le premier jumeau est en présentation céphalique et n’est pas significativement plus petit que le deuxième jumeau, il convient de proposer l’accouchement vaginal lorsqu’un fournisseur de soins compétent dans la prise en charge de l’accouchement d’un deuxième jumeau en présentation non céphalique est disponible, quelle que soit la présentation du deuxième jumeau (forte, élevée).
      • 12.
        Si le deuxième jumeau est en présentation non céphalique, la version podalique interne avec extraction par le siège est recommandée (forte, élevée).

      Mots clés

      Abréviations:

      DAT (déclenchement artificiel du travail), ECR (essai clinique randomisé), EDTAC (épreuve de travail après césarienne), LCC (longueur céphalo-caudale), PFE (poids fœtal estimé), PVC (prélèvement de villosités choriales), RCIU (retard de croissance intra-utérin), SA (semaine d’aménorrhée), TPA (technologie de procréation assistée), VPI (version podalique interne)
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      Références

        • Fell D.B.
        • Joseph K.
        Temporal trends in the frequency of twins and higher-order multiple births in Canada and the United States.
        BMC Pregnancy Childbirth. 2012; 12: 103
        • Joseph K.S.
        • Kramer M.S.
        • Marcoux S.
        • et al.
        Determinants of preterm birth rates in Canada from 1981 through 1983 and from 1992 through 1994.
        N Engl J Med. 1998; 339: 1434-1439
        • Barrett J.F.
        • Hannah M.E.
        • Hutton E.K.
        • et al.
        A randomized trial of planned cesarean or vaginal delivery for twin pregnancy.
        N Engl J Med. 2013; 369: 1295-1305
        • Audibert F.
        • Gagnon A.
        • No
        262-prenatal screening for and diagnosis of aneuploidy in twin pregnancies.
        J Obstet Gynaecol Can. 2017; 39: e347-e361
        • Shah P.S.
        • McDonald S.D.
        • Barrett J.
        • et al.
        The Canadian Preterm Birth Network: a study protocol for improving outcomes for preterm infants and their families.
        CMAJ Open. 2018; 6: E44-E49
      1. Statistics Canada. Table 13-10-0428-01. Live births and fetal deaths (stillbirths), by type of birth (single or multiple). Avaialble at: https://doi.org/10.25318/1310042801-eng. Accessed on September 28, 2021.

        • Maruotti G.M.
        • Saccone G.
        • Morlando M.
        • et al.
        First-trimester ultrasound determination of chorionicity in twin gestations using the lambda sign: a systematic review and meta-analysis.
        Eur J Obstet Gynecol Reprod Biol. 2016; 202: 66-70
        • Stenhouse E.
        • Hardwick C.
        • Maharaj S.
        • et al.
        Chorionicity determination in twin pregnancies: how accurate are we?.
        Ultrasound Obstet Gynecol. 2002; 19: 350-352
        • Carroll S.G.
        • Soothill P.W.
        • Abdel-Fattah S.A.
        • et al.
        Prediction of chorionicity in twin pregnancies at 10-14 weeks of gestation.
        BJOG. 2002; 109: 182-186
        • Lu J.
        • Cheng Y.K.Y.
        • Ting Y.H.
        • et al.
        Pitfalls in assessing chorioamnionicity: novel observations and literature review.
        Am J Obstet Gynecol. 2018; 219: 242-254
        • Sepulveda W.
        • Sebire N.J.
        • Hughes K.
        • et al.
        Evolution of the lambda or twin-chorionic peak sign in dichorionic twin pregnancies.
        Obstet Gynecol. 1997; 89: 439-441
        • Salomon L.J.
        • Cavicchioni O.
        • Bernard J.P.
        • et al.
        Growth discrepancy in twins in the first trimester of pregnancy.
        Ultrasound Obstet Gynecol. 2005; 26: 512-516
        • Sebire N.J.
        • D'Ercole C.
        • Soares W.
        • et al.
        Intertwin disparity in fetal size in monochorionic and dichorionic pregnancies.
        Obstet Gynecol. 1998; 91: 82-85
        • D'Antonio F.
        • Khalil A.
        • Dias T.
        • et al.
        Crown-rump length discordance and adverse perinatal outcome in twins: analysis of the Southwest Thames Obstetric Research Collaborative (STORK) multiple pregnancy cohort.
        Ultrasound Obstet Gynecol. 2013; 41: 621-626
        • D'Antonio F.
        • Khalil A.
        • Pagani G.
        • et al.
        Crown-rump length discordance and adverse perinatal outcome in twin pregnancies: systematic review and meta-analysis.
        Ultrasound Obstet Gynecol. 2014; 44: 138-146
        • Litwinska E.
        • Syngelaki A.
        • Cimpoca B.
        • et al.
        Intertwin discordance in fetal size at 11-13 weeks' gestation and pregnancy outcome.
        Ultrasound Obstet Gynecol. 2020; 55: 189-197
        • Chaudhuri K.
        • Su L.L.
        • Wong P.C.
        • et al.
        Determination of gestational age in twin pregnancy: which fetal crown-rump length should be used?.
        J Obstet Gynaecol Res. 2013; 39: 761-765
        • DeYoung T.H.
        • Stortz S.K.
        • Riffenburgh R.H.
        • et al.
        Establishing the most accurate due date in dichorionic twin gestations by first and second trimester ultrasound.
        J Ultrasound Med. 2021; 40: 2319-2327
        • Dias T.
        • Mahsud-Dornan S.
        • Thilaganathan B.
        • et al.
        First-trimester ultrasound dating of twin pregnancy: are singleton charts reliable?.
        BJOG. 2010; 117: 979-984
        • Chervenak F.A.
        • Skupski D.W.
        • Romero R.
        • et al.
        How accurate is fetal biometry in the assessment of fetal age?.
        Am J Obstet Gynecol. 1998; 178: 678-687
        • Dias T.
        • Arcangeli T.
        • Bhide A.
        • et al.
        Second-trimester assessment of gestational age in twins: validation of singleton biometry charts.
        Ultrasound Obstet Gynecol. 2011; 37: 34-37
        • Dias T.
        • Ladd S.
        • Mahsud-Dornan S.
        • et al.
        Systematic labeling of twin pregnancies on ultrasound.
        Ultrasound Obstet Gynecol. 2011; 38: 130-133
        • Harris A.L.
        • Sacha C.R.
        • Basnet K.M.
        • et al.
        Vanishing twins conceived through fresh in vitro fertilization: obstetric outcomes and placental pathology.
        Obstet Gynecol. 2020; 135: 1426-1433
        • Seong J.S.
        • Han Y.J.
        • Kim M.H.
        • et al.
        The risk of preterm birth in vanishing twin: a multicenter prospective cohort study.
        PLoS One. 2020; 15e0233097
        • Mackie F.L.
        • Rigby A.
        • Morris R.K.
        • et al.
        Prognosis of the co-twin following spontaneous single intrauterine fetal death in twin pregnancies: a systematic review and meta-analysis.
        BJOG. 2019; 126: 569-578
        • Shek N.W.
        • Hillman S.C.
        • Kilby M.D.
        Single-twin demise: pregnancy outcome.
        Best Pract Res Clin Obstet Gynaecol. 2014; 28: 249-263
        • Cimpoca B.
        • Syngelaki A.
        • Chi Mu A.
        • et al.
        Twin pregnancy with two live fetuses at 11-13 weeks: effect of one fetal death on pregnancy outcome.
        Ultrasound Obstet Gynecol. 2020; 55: 482-488
        • Hillman S.C.
        • Morris R.K.
        • Kilby M.D.
        Co-twin prognosis after single fetal death: a systematic review and meta-analysis.
        Obstet Gynecol. 2011; 118: 928-940
        • Rodis J.F.
        • Egan J.F.
        • Craffey A.
        • et al.
        Calculated risk of chromosomal abnormalities in twin gestations.
        Obstet Gynecol. 1990; 76: 1037-1041
        • Sparks T.N.
        • Norton M.E.
        • Flessel M.
        • et al.
        Observed rate of Down syndrome in twin pregnancies.
        Obstet Gynecol. 2016; 128: 1127-1133
        • Boyle B.
        • Morris J.K.
        • McConkey R.
        • et al.
        Prevalence and risk of Down syndrome in monozygotic and dizygotic multiple pregnancies in Europe: implications for prenatal screening.
        BJOG. 2014; 121 ([discussion 820]): 809-819
        • Audibert F.
        • De Bie I.
        • Johnson J.A.
        • et al.
        No. 348-joint SOGC-CCMG guideline: update on prenatal screening for fetal aneuploidy, fetal anomalies, and adverse pregnancy outcomes.
        J Obstet Gynaecol Can. 2017; 39: 805-817
        • Akolekar R.
        • Beta J.
        • Picciarelli G.
        • et al.
        Procedure-related risk of miscarriage following amniocentesis and chorionic villus sampling: a systematic review and meta-analysis.
        Ultrasound Obstet Gynecol. 2015; 45: 16-26
        • Wulff C.B.
        • Gerds T.A.
        • Rode L.
        • et al.
        Risk of fetal loss associated with invasive testing following combined first-trimester screening for Down syndrome: a national cohort of 147,987 singleton pregnancies.
        Ultrasound Obstet Gynecol. 2016; 47: 38-44
        • Agarwal K.
        • Alfirevic Z.
        Pregnancy loss after chorionic villus sampling and genetic amniocentesis in twin pregnancies: a systematic review.
        Ultrasound Obstet Gynecol. 2012; 40: 128-134
        • Simonazzi G.
        • Curti A.
        • Farina A.
        • et al.
        Amniocentesis and chorionic villus sampling in twin gestations: which is the best sampling technique?.
        Am J Obstet Gynecol. 2010; 202: 365.e361-365.e365
        • Tafforeau J.
        • Papiernik E.
        • Richard A.
        • et al.
        Is prevention of preterm births in twin pregnancies possible? Analysis of the results of a prevention program in France (1989-1991).
        Eur J Obstet Gynecol Reprod Biol. 1995; 59: 169-174
        • Shamshirsaz A.A.
        • Haeri S.
        • Ravangard S.F.
        • et al.
        Perinatal outcomes based on the institute of medicine guidelines for weight gain in twin pregnancies.
        J Matern Fetal Neonatal Med. 2014; 27: 552-556
        • Glinianaia S.V.
        • Rankin J.
        • Wright C.
        Congenital anomalies in twins: a register-based study.
        Hum Reprod. 2008; 23: 1306-1311
        • Morin L.
        • Lim K.
        • No
        260-ultrasound in twin pregnancies.
        J Obstet Gynaecol Can. 2017; 39: e398-e411
        • Cargill Y.
        • Morin L.
        No. 223-content of a complete routine second trimester obstetrical ultrasound examination and report.
        J Obstet Gynaecol Can. 2017; 39: e144-e149
        • No Gagnon R.
        231-guidelines for the management of vasa previa.
        J Obstet Gynaecol Can. 2017; 39: e415-e421
        • Jain V.
        • Bos H.
        • Bujold E.
        Guideline no. 402: diagnosis and management of placenta previa.
        J Obstet Gynaecol Can. 2020; 42: 906-917.e901
        • Corcoran S.
        • Breathnach F.
        • Burke G.
        • et al.
        Dichorionic twin ultrasound surveillance: sonography every 4 weeks significantly underperforms sonography every 2 weeks: results of the prospective multicenter ESPRiT study.
        Am J Obstet Gynecol. 2015; 213 (551.e551–5)
        • Woolcock J.G.
        • Grivell R.M.
        • Dodd J.M.
        Regimens of ultrasound surveillance for twin pregnancies for improving outcomes.
        Cochrane Database Syst Rev. 2017; 11: CD011371
        • Grantz K.L.
        • Grewal J.
        • Albert P.S.
        • et al.
        Dichorionic twin trajectories: the NICHD Fetal Growth Studies.
        Am J Obstet Gynecol. 2016; 215 (221.e221-221.e216)
        • Mendez-Figueroa H.
        • Truong V.T.T.
        • Pedroza C.
        • et al.
        Growth among twins: use of singleton versus twin-specific growth nomograms.
        Am J Perinatol. 2018; 35: 184-191
        • Kibel M.
        • Kahn M.
        • Sherman C.
        • et al.
        Placental abnormalities differ between small for gestational age fetuses in dichorionic twin and singleton pregnancies.
        Placenta. 2017; 60: 28-35
        • Proctor L.K.
        • Kfouri J.
        • Hiersch L.
        • et al.
        Association between hypertensive disorders and fetal growth restriction in twin compared with singleton gestations.
        Am J Obstet Gynecol. 2019; 221: 251.e251-251.e258
        • Muhlhausler B.S.
        • Hancock S.N.
        • Bloomfield F.H.
        • et al.
        Are twins growth restricted?.
        Pediatr Res. 2011; 70: 117-122
        • Khalil A.
        • Rodgers M.
        • Baschat A.
        • et al.
        ISUOG practice guidelines: role of ultrasound in twin pregnancy.
        Ultrasound Obstet Gynecol. 2016; 47: 247-263
        • Kalafat E.
        • Sebghati M.
        • Thilaganathan B.
        • et al.
        Predictive accuracy of Southwest Thames Obstetric Research Collaborative (STORK) chorionicity-specific twin growth charts for stillbirth: a validation study.
        Ultrasound Obstet Gynecol. 2019; 53: 193-199
        • Shea S.K.
        • Likins B.J.
        • Boan A.D.
        • et al.
        Dichorionic twin-specific vs singleton growth references for diagnosis of fetal growth restriction.
        Am J Obstet Gynecol. 2021; 224: 603.e601-603.e609
        • D'Antonio F.
        • Odibo A.O.
        • Prefumo F.
        • et al.
        Weight discordance and perinatal mortality in twin pregnancy: systematic review and meta-analysis.
        Ultrasound Obstet Gynecol. 2018; 52: 11-23
        • Jahanfar S.
        • Ho J.J.
        • Jaafar S.H.
        • et al.
        Ultrasound for diagnosis of birth weight discordance in twin pregnancies.
        Cochrane Database Syst Rev. 2021; : CD012553
        • D'Antonio F.
        • Khalil A.
        • Dias T.
        • et al.
        Weight discordance and perinatal mortality in twins: analysis of the Southwest Thames Obstetric Research Collaborative (STORK) multiple pregnancy cohort.
        Ultrasound Obstet Gynecol. 2013; 41: 643-648
        • Khalil A.
        • Beune I.
        • Hecher K.
        • et al.
        Consensus definition and essential reporting parameters of selective fetal growth restriction in twin pregnancy: a Delphi procedure.
        Ultrasound Obstet Gynecol. 2019; 53: 47-54
        • Booker W.
        • Fox N.S.
        • Gupta S.
        • et al.
        Antenatal surveillance in twin pregnancies using the biophysical profile.
        J Ultrasound Med. 2015; 34: 2071-2075
        • Melamed N.
        • Baschat A.
        • Yinon Y.
        • et al.
        FIGO (International Federation of Gynecology and Obstetrics) initiative on fetal growth: best practice advice for screening, diagnosis, and management of fetal growth restriction.
        Int J Gynaecol Obstet. 2021; 152: 3-57
        • Conde-Agudelo A.
        • Romero R.
        • Hassan S.S.
        • et al.
        Transvaginal sonographic cervical length for the prediction of spontaneous preterm birth in twin pregnancies: a systematic review and metaanalysis.
        Am J Obstet Gynecol. 2010; 203 (128.e121–112)
        • Butt K.
        • Crane J.
        • Hutcheon J.
        • et al.
        No. 374-universal cervical length screening.
        J Obstet Gynaecol Can. 2019; 41: 363-374.e361
        • Conde-Agudelo A.
        • Romero R.
        Prediction of preterm birth in twin gestations using biophysical and biochemical tests.
        Am J Obstet Gynecol. 2014; 211: 583-595
        • Gordon M.C.
        • McKenna D.S.
        • Stewart T.L.
        • et al.
        Transvaginal cervical length scans to prevent prematurity in twins: a randomized controlled trial.
        Am J Obstet Gynecol. 2016; 214: 277.e271-277.e277
        • Melamed N.
        • Pittini A.
        • Hiersch L.
        • et al.
        Do serial measurements of cervical length improve the prediction of preterm birth in asymptomatic women with twin gestations?.
        Am J Obstet Gynecol. 2016; 215: 616.e611-616.e614
        • Lipworth H.
        • Hiersch L.
        • Farine D.
        • et al.
        Current practice of maternal-fetal medicine specialists regarding the prevention and management of preterm birth in twin gestations.
        J Obstet Gynaecol Can. 2021; 43: 831-838
        • Gent J.
        • Nanda S.
        • Khalil A.
        • et al.
        Antenatal management of multiple pregnancies within the UK: a survey of practice.
        Eur J Obstet Gynecol Reprod Biol. 2020; 254: 74-78
        • Melamed N.
        • Pittini A.
        • Hiersch L.
        • et al.
        Serial cervical length determination in twin pregnancies reveals 4 distinct patterns with prognostic significance for preterm birth.
        Am J Obstet Gynecol. 2016; 215 (476.e471–476.e411)
        • Brown R.
        • Gagnon R.
        • Delisle M.F.
        No. 373-cervical insufficiency and cervical cerclage.
        J Obstet Gynaecol Can. 2019; 41: 233-247
        • Bergh E.
        • Rebarber A.
        • Oppal S.
        • et al.
        The association between maternal biomarkers and pathways to preterm birth in twin pregnancies.
        J Matern Fetal Neonatal Med. 2015; 28: 504-508
        • Melchor J.C.
        • Khalil A.
        • Wing D.
        • et al.
        Prediction of preterm delivery in symptomatic women using PAMG-1, fetal fibronectin and phIGFBP-1 tests: systematic review and meta-analysis.
        Ultrasound Obstet Gynecol. 2018; 52: 442-451
        • Fichera A.
        • Prefumo F.
        • Zanardini C.
        • et al.
        Rapid cervical phIGFBP-1 test in asymptomatic twin pregnancies: role in mid-pregnancy prediction of spontaneous preterm delivery.
        Prenat Diagn. 2014; 34: 450-459
        • Crowther C.A.
        • Han S.
        Hospitalisation and bed rest for multiple pregnancy.
        Cochrane Database Syst Rev. 2010; 7: CD000110
        • da Silva Lopes K.
        • Takemoto Y.
        • Ota E.
        • et al.
        Bed rest with and without hospitalisation in multiple pregnancy for improving perinatal outcomes.
        Cochrane Database Syst Rev. 2017; 3: CD012031
        • Rydhström H.
        Twin pregnancy and the effects of prophylactic leave of absence on pregnancy duration and birth weight.
        Acta Obstet Gynecol Scand. 1988; 67: 81-84
        • Jain V.
        Choosing wisely: bedrest-a panacea for all that ails the gravida?.
        J Obstet Gynaecol Can. 2019; 41: 971-973
        • Bigelow C.
        • Stone J.
        Bed rest in pregnancy.
        Mt Sinai J Med. 2011; 78: 291-302
        • Mottola M.F.
        • Davenport M.H.
        • Ruchat S.M.
        • et al.
        No. 367-2019 Canadian guideline for physical activity throughout pregnancy.
        J Obstet Gynaecol Can. 2018; 40: 1528-1537
        • Rafael T.J.
        • Berghella V.
        • Alfirevic Z.
        Cervical stitch (cerclage) for preventing preterm birth in multiple pregnancy.
        Cochrane Database Syst Rev. 2014; 9: CD009166
        • Li C.
        • Shen J.
        • Hua K.
        Cerclage for women with twin pregnancies: a systematic review and metaanalysis.
        Am J Obstet Gynecol. 2019; 220: 543-557.e541
        • Rottenstreich A.
        • Levin G.
        • Kleinstern G.
        • et al.
        History-indicated cervical cerclage in management of twin pregnancy.
        Ultrasound Obstet Gynecol. 2019; 54: 517-523
        • Berghella V.
        • Odibo A.O.
        • To M.S.
        • et al.
        Cerclage for short cervix on ultrasonography: meta-analysis of trials using individual patient-level data.
        Obstet Gynecol. 2005; 106: 181-189
        • Newman R.B.
        • Krombach R.S.
        • Myers M.C.
        • et al.
        Effect of cerclage on obstetrical outcome in twin gestations with a shortened cervical length.
        Am J Obstet Gynecol. 2002; 186: 634-640
        • Saccone G.
        • Rust O.
        • Althuisius S.
        • et al.
        Cerclage for short cervix in twin pregnancies: systematic review and meta-analysis of randomized trials using individual patient-level data.
        Acta Obstet Gynecol Scand. 2015; 94: 352-358
        • Houlihan C.
        • Poon L.C.
        • Ciarlo M.
        • et al.
        Cervical cerclage for preterm birth prevention in twin gestation with short cervix: a retrospective cohort study.
        Ultrasound Obstet Gynecol. 2016; 48: 752-756
        • Roman A.
        • Rochelson B.
        • Fox N.S.
        • et al.
        Efficacy of ultrasound-indicated cerclage in twin pregnancies.
        Am J Obstet Gynecol. 2015; 212: 788.e781-788.e786
        • Roman A.
        • Rochelson B.
        • Martinelli P.
        • et al.
        Cerclage in twin pregnancy with dilated cervix between 16 to 24 weeks of gestation: retrospective cohort study.
        Am J Obstet Gynecol. 2016; 215 (98.e91–98.e11)
        • Abbasi N.
        • Barrett J.
        • Melamed N.
        Outcomes following rescue cerclage in twin pregnancies.
        J Matern Fetal Neonatal Med. 2018; 31: 2195-2201
        • Roman A.
        • Zork N.
        • Haeri S.
        • et al.
        Physical examination-indicated cerclage in twin pregnancy: a randomized controlled trial.
        Am J Obstet Gynecol. 2020; 223: 902.e901-902.e911
        • Norman J.E.
        • Mackenzie F.
        • Owen P.
        • et al.
        Progesterone for the prevention of preterm birth in twin pregnancy (STOPPIT): a randomised, double-blind, placebo-controlled study and meta-analysis.
        Lancet. 2009; 373: 2034-2040
        • Dodd J.M.
        • Grivell R.M.
        • CM O.B.
        • et al.
        Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy.
        Cochrane Database Syst Rev. 2019; 11
        • Jarde A.
        • Lutsiv O.
        • Park C.K.
        • et al.
        Preterm birth prevention in twin pregnancies with progesterone, pessary, or cerclage: a systematic review and meta-analysis.
        BJOG. 2017; 124: 1163-1173
        • Romero R.
        • Conde-Agudelo A.
        • El-Refaie W.
        • et al.
        Vaginal progesterone decreases preterm birth and neonatal morbidity and mortality in women with a twin gestation and a short cervix: an updated meta-analysis of individual patient data.
        Ultrasound Obstet Gynecol. 2017; 49: 303-314
        • Schuit E.
        • Stock S.
        • Rode L.
        • et al.
        Effectiveness of progestogens to improve perinatal outcome in twin pregnancies: an individual participant data meta-analysis.
        BJOG. 2015; 122: 27-37
        • Rehal A.
        • Benkő Z.
        • De Paco Matallana C.
        • et al.
        Early vaginal progesterone versus placebo in twin pregnancies for the prevention of spontaneous preterm birth: a randomized, double-blind trial.
        Am J Obstet Gynecol. 2021; 224 (86.e81–86.e19)
        • Romero R.
        • Conde-Agudelo A.
        • Rehal A.
        • et al.
        Vaginal progesterone for prevention of preterm birth and adverse perinatal outcomes in twin gestation with a short cervix: an updated individual patient data meta-analysis.
        Ultrasound Obstet Gynecol. 2022; 59: 263-266
        • Jain V.
        • McDonald S.D.
        • Mundle W.R.
        • et al.
        Guideline no. 398: progesterone for prevention of spontaneous preterm birth.
        J Obstet Gynaecol Can. 2020; 42: 806-812
        • Nicolaides K.H.
        • Syngelaki A.
        • Poon L.C.
        • et al.
        Cervical pessary placement for prevention of preterm birth in unselected twin pregnancies: a randomized controlled trial.
        Am J Obstet Gynecol. 2016; 214: 3.e1-3.e9
        • Liem S.
        • Schuit E.
        • Hegeman M.
        • et al.
        Cervical pessaries for prevention of preterm birth in women with a multiple pregnancy (ProTWIN): a multicentre, open-label randomised controlled trial.
        Lancet. 2013; 382: 1341-1349
        • Merced C.
        • Goya M.
        • Pratcorona L.
        • et al.
        Cervical pessary for preventing preterm birth in twin pregnancies with maternal short cervix after an episode of threatened preterm labor: randomised controlled trial.
        Am J Obstet Gynecol. 2019; 221 (55.e51–55.e14)
        • Goya M.
        • de la Calle M.
        • Pratcorona L.
        • et al.
        Cervical pessary to prevent preterm birth in women with twin gestation and sonographic short cervix: a multicenter randomized controlled trial (PECEP-Twins).
        Am J Obstet Gynecol. 2016; 214: 145-152
        • Thangatorai R.
        • Lim F.C.
        • Nalliah S.
        Cervical pessary in the prevention of preterm births in multiple pregnancies with a short cervix: PRISMA compliant systematic review and meta-analysis.
        J Matern Fetal Neonatal Med. 2018; 31: 1638-1645
        • Berghella V.
        • Dugoff L.
        • Ludmir J.
        Prevention of preterm birth with pessary in twins (PoPPT): a randomized controlled trial.
        Ultrasound Obstet Gynecol. 2017; 49: 567-572
        • Yamasmit W.
        • Chaithongwongwatthana S.
        • Tolosa J.E.
        • et al.
        Prophylactic oral betamimetics for reducing preterm birth in women with a twin pregnancy.
        Cochrane Database Syst Rev. 2012; 9: CD004733
        • Derbent A.
        • Simavli S.
        • Gümüş I.I.
        • et al.
        Nifedipine for the treatment of preterm labor in twin and singleton pregnancies.
        Arch Gynecol Obstet. 2011; 284: 821-826
        • Klam S.L.
        • Leduc L.
        Management options for preterm labour in Canada.
        J Obstet Gynaecol Can. 2004; 26: 339-345
        • Murphy D.J.
        • Caukwell S.
        • Joels L.A.
        • et al.
        Cohort study of the neonatal outcome of twin pregnancies that were treated with prophylactic or rescue antenatal corticosteroids.
        Am J Obstet Gynecol. 2002; 187: 483-488
        • Skoll A.
        • Boutin A.
        • Bujold E.
        • et al.
        No. 364-antenatal corticosteroid therapy for improving neonatal outcomes.
        J Obstet Gynaecol Can. 2018; 40: 1219-1239
        • Melamed N.
        • Shah J.
        • Yoon E.W.
        • et al.
        The role of antenatal corticosteroids in twin pregnancies complicated by preterm birth.
        Am J Obstet Gynecol. 2016; 215: 482.e481-482.e489
        • Ushida T.
        • Kotani T.
        • Sadachi R.
        • et al.
        Antenatal corticosteroids and outcomes in preterm twins.
        Obstet Gynecol. 2020; 135: 1387-1397
        • Palas D.
        • Ehlinger V.
        • Alberge C.
        • et al.
        Efficacy of antenatal corticosteroids in preterm twins: the EPIPAGE-2 cohort study.
        BJOG. 2018; 125: 1164-1170
        • Bartsch E.
        • Medcalf K.E.
        • Park A.L.
        • et al.
        Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies.
        BMJ. 2016; 353: i1753
        • Magee L.A.
        • Smith G.N.
        • Bloch C.
        • et al.
        Guideline no. 426: hypertensive disoders of pregnancy: diagnosis, prediction, prevention, and management.
        J Obstet Gynaecol Can. 2022; : 44
        • Luke B.
        • Hediger M.L.
        • Nugent C.
        • et al.
        Body mass index--specific weight gains associated with optimal birth weights in twin pregnancies.
        J Reprod Med. 2003; 48: 217-224
        • Lutsiv O.
        • Hulman A.
        • Woolcott C.
        • et al.
        Examining the provisional guidelines for weight gain in twin pregnancies: a retrospective cohort study.
        BMC Pregnancy Childbirth. 2017; 17: 330
        • Bricker L.
        • Reed K.
        • Wood L.
        • et al.
        Nutritional advice for improving outcomes in multiple pregnancies.
        Cochrane Database Syst Rev. 2015; 11: CD008867
        • Goodnight W.
        • Newman R.
        Optimal nutrition for improved twin pregnancy outcome.
        Obstet Gynecol. 2009; 114: 1121-1134
        • O'Connor D.L.
        • Blake J.
        • Bell R.
        • et al.
        Canadian consensus on female nutrition: adolescence, reproduction, menopause, and beyond.
        J Obstet Gynaecol Can. 2016; 38: 508-554.e518
        • Kahn B.
        • Lumey L.H.
        • Zybert P.A.
        • et al.
        Prospective risk of fetal death in singleton, twin, and triplet gestations: implications for practice.
        Obstet Gynecol. 2003; 102: 685-692
        • Dodd J.M.
        • Robinson J.S.
        • Crowther C.A.
        • et al.
        Stillbirth and neonatal outcomes in South Australia, 1991-2000.
        Am J Obstet Gynecol. 2003; 189: 1731-1736
        • Cheong-See F.
        • Schuit E.
        • Arroyo-Manzano D.
        • et al.
        Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis.
        BMJ. 2016; 354: i4353
        • Dodd J.M.
        • Deussen A.R.
        • Grivell R.M.
        • et al.
        Elective birth at 37 weeks' gestation for women with an uncomplicated twin pregnancy.
        Cochrane Database Syst Rev. 2014; : CD003582
        • Schmitz T.
        • Prunet C.
        • Azria E.
        • et al.
        Association between planned cesarean delivery and neonatal mortality and morbidity in twin pregnancies.
        Obstet Gynecol. 2017; 129: 986-995
        • Goossens S.
        • Ensing S.
        • van der Hoeven M.
        • et al.
        Comparison of planned caesarean delivery and planned vaginal delivery in women with a twin pregnancy: a nation wide cohort study.
        Eur J Obstet Gynecol Reprod Biol. 2018; 221: 97-104
        • Ylilehto E.
        • Palomäki O.
        • Huhtala H.
        • et al.
        Risk factors of unsuccessful vaginal twin delivery.
        Acta Obstet Gynecol Scand. 2020; 99: 1504-1510
        • Dong Y.
        • Luo Z.C.
        • Yang Z.J.
        • et al.
        Is cesarean delivery preferable in twin pregnancies at >=36 weeks gestation?.
        PLoS One. 2016; 11e0155692
        • Zafarmand M.H.
        • Goossens S.
        • Tajik P.
        • et al.
        Planned Cesarean or planned vaginal delivery for twins: secondary analysis of randomized controlled trial.
        Ultrasound Obstet Gynecol. 2021; 57: 582-591
        • Dougan C.
        • Gotha L.
        • Melamed N.
        • et al.
        Cesarean delivery or induction of labor in pre-labor twin gestations: a secondary analysis of the twin birth study.
        BMC Pregnancy Childbirth. 2020; 20: 702
        • Hofmeyr G.J.
        • Barrett J.F.
        • Crowther C.A.
        Planned caesarean section for women with a twin pregnancy.
        Cochrane Database Syst Rev. 2015; 12: CD006553
        • Hutton E.K.
        • Hannah M.E.
        • Ross S.
        • et al.
        Maternal outcomes at 3 months after planned caesarean section versus planned vaginal birth for twin pregnancies in the Twin Birth Study: a randomised controlled trial.
        BJOG. 2015; 122: 1653-1662
        • Asztalos E.V.
        • Hannah M.E.
        • Hutton E.K.
        • et al.
        Twin Birth Study: 2-year neurodevelopmental follow-up of the randomized trial of planned cesarean or planned vaginal delivery for twin pregnancy.
        Am J Obstet Gynecol. 2016; 214 (371.e371–371.e319)
        • Aviram A.
        • Lipworth H.
        • Asztalos E.V.
        • et al.
        The worst of both worlds-combined deliveries in twin gestations: a subanalysis of the Twin Birth Study, a randomized, controlled, prospective study.
        Am J Obstet Gynecol. 2019; 221: 353.e351-353.e357
        • Blickstein I.
        • Goldman R.D.
        • Kupferminc M.
        Delivery of breech first twins: a multicenter retrospective study.
        Obstet Gynecol. 2000; 95: 37-42
        • Sentilhes L.
        • Goffinet F.
        • Talbot A.
        • et al.
        Attempted vaginal versus planned cesarean delivery in 195 breech first twin pregnancies.
        Acta Obstet Gynecol Scand. 2007; 86: 55-60
        • Hannah M.E.
        • Hannah W.J.
        • Hewson S.A.
        • et al.
        Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group.
        Lancet. 2000; 356: 1375-1383
        • Hogle K.L.
        • Hutton E.K.
        • McBrien K.A.
        • et al.
        Cesarean delivery for twins: a systematic review and meta-analysis.
        Am J Obstet Gynecol. 2003; 188: 220-227
        • Nassar A.H.
        • Maarouf H.H.
        • Hobeika E.M.
        • et al.
        Breech presenting twin A: is vaginal delivery safe?.
        J Perinat Med. 2004; 32: 470-474
        • Kotaska A.
        • Menticoglou S.
        • No
        384-management of breech presentation at term.
        J Obstet Gynaecol Can. 2019; 41: 1193-1205
        • Schmitz T.
        • Korb D.
        • Battie C.
        • et al.
        Neonatal morbidity associated with vaginal delivery of noncephalic second twins.
        Am J Obstet Gynecol. 2018; 218 (449.e441–449.e413)
        • Panelli D.M.
        • Easter S.R.
        • Bibbo C.
        • et al.
        Clinical factors associated with presentation change of the second twin after vaginal delivery of the first twin.
        Obstet Gynecol. 2017; 130: 1104-1111
        • Chauhan S.P.
        • Roberts W.E.
        • McLaren R.A.
        • et al.
        Delivery of the nonvertex second twin: breech extraction versus external cephalic version.
        Am J Obstet Gynecol. 1995; 173: 1015-1020
        • Jonsdottir F.
        • Henriksen L.
        • Secher N.J.
        • et al.
        Does internal podalic version of the non-vertex second twin still have a place in obstetrics? A Danish national retrospective cohort study.
        Acta Obstet Gynecol Scand. 2015; 94: 59-64
        • Carvalho B.
        • Saxena A.
        • Butwick A.
        • et al.
        Vaginal twin delivery: a survey and review of location, anesthesia coverage and interventions.
        Int J Obstet Anesth. 2008; 17: 212-216
        • Vayssière C.
        • Benoist G.
        • Blondel B.
        • et al.
        Twin pregnancies: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF).
        Eur J Obstet Gynecol Reprod Biol. 2011; 156: 12-17
        • Vinatier D.
        • Dufour P.
        • Bérard J.
        Utilization of intravenous nitroglycerin for obstetrical emergencies.
        Int J Gynaecol Obstet. 1996; 55: 129-134
        • Dufour P.
        • Vinatier D.
        • Puech F.
        The use of intravenous nitroglycerin for cervico-uterine relaxation: a review of the literature.
        Arch Gynecol Obstet. 1997; 261: 1-7
        • Tal A.
        • Peretz H.
        • Garmi G.
        • et al.
        Effect of inter-twin delivery interval on umbilical artery pH and Apgar score in the second twin.
        Birth. 2018; 45: 37-42
        • Algeri P.
        • Callegari C.
        • Bernasconi D.P.
        • et al.
        Neonatal hypoxia of the second twin after vaginal delivery of the first twin: what matters?.
        J Matern Fetal Neonatal Med. 2019; 32: 2889-2896
        • Miller J.
        • Chauhan S.P.
        • Abuhamad A.Z.
        Discordant twins: diagnosis, evaluation and management.
        Am J Obstet Gynecol. 2012; 206: 10-20
        • Lindroos L.
        • Elfvin A.
        • Ladfors L.
        • et al.
        The effect of twin-to-twin delivery time intervals on neonatal outcome for second twins.
        BMC Pregnancy Childbirth. 2018; 18: 36
        • Hjortø S.
        • Nickelsen C.
        • Petersen J.
        • et al.
        The effect of chorionicity and twin-to-twin delivery time interval on short-term outcome of the second twin.
        J Matern Fetal Neonatal Med. 2014; 27: 42-47
        • Yang Q.
        • Wen S.W.
        • Chen Y.
        • et al.
        Neonatal mortality and morbidity in vertex-vertex second twins according to mode of delivery and birth weight.
        J Perinatol. 2006; 26: 3-10
        • Armson B.A.
        • O'Connell C.
        • Persad V.
        • et al.
        Determinants of perinatal mortality and serious neonatal morbidity in the second twin.
        Obstet Gynecol. 2006; 108: 556-564
      2. Easter SR, Taouk L, Schulkin J, et al. Twin vaginal delivery: innovate or abdicate. Am J Obstet Gynecol 2017;216:484-488.e484.

        • Dagenais C.
        • Lewis-Mikhael A.M.
        • Grabovac M.
        • et al.
        What is the safest mode of delivery for extremely preterm cephalic/non-cephalic twin pairs? A systematic review and meta-analyses.
        BMC Pregnancy Childbirth. 2017; 17: 397
        • Sentilhes L.
        • Oppenheimer A.
        • Bouhours A.C.
        • et al.
        Neonatal outcome of very preterm twins: policy of planned vaginal or cesarean delivery.
        Am J Obstet Gynecol. 2015; 213: 73.e71-73.e77
        • Barzilay E.
        • Mazaki-Tovi S.
        • Amikam U.
        • et al.
        Mode of delivery of twin gestation with very low birthweight: is vaginal delivery safe?.
        Am J Obstet Gynecol. 2015; 213: 219.e211-219.e218
        • Branum A.M.
        • Schoendorf K.C.
        The effect of birth weight discordance on twin neonatal mortality.
        Obstet Gynecol. 2003; 101: 570-574
        • Kontopoulos E.V.
        • Ananth C.V.
        • Smulian J.C.
        • et al.
        The influence of mode of delivery on twin neonatal mortality in the US: variance by birth weight discordance.
        Am J Obstet Gynecol. 2005; 192: 252-256
        • Baschat A.A.
        Fetal growth restriction - from observation to intervention.
        J Perinat Med. 2010; 38: 239-246
        • Kabiri D.
        • Masarwy R.
        • Schachter-Safrai N.
        • et al.
        Trial of labor after cesarean delivery in twin gestations: systematic review and meta-analysis.
        Am J Obstet Gynecol. 2019; 220: 336-347
        • Shinar S.
        • Agrawal S.
        • Hasan H.
        • et al.
        Trial of labor versus elective repeat cesarean delivery in twin pregnancies after a previous cesarean delivery-A systematic review and meta-analysis.
        Birth. 2019; 46: 550-559
        • Varner M.W.
        • Leindecker S.
        • Spong C.Y.
        • et al.
        The Maternal-Fetal Medicine Unit cesarean registry: trial of labor with a twin gestation.
        Am J Obstet Gynecol. 2005; 193: 135-140
        • Benito Vielba M.
        • De Bonrostro Torralba C.
        • Pallares Arnal V.
        • et al.
        Delayed-interval delivery in twin pregnancies: report of three cases and literature review.
        J Matern Fetal Neonatal Med. 2019; 32: 351-355
        • Zhang J.
        • Hamilton B.
        • Martin J.
        • et al.
        Delayed interval delivery and infant survival: a population-based study.
        Am J Obstet Gynecol. 2004; 191: 470-476
        • Arabin B.
        • van Eyck J.
        Delayed-interval delivery in twin and triplet pregnancies: 17 years of experience in 1 perinatal center.
        Am J Obstet Gynecol. 2009; 200: 154.e1-154.e8
        • Loscul C.
        • Schmitz T.
        • Blanc-Petitjean P.
        • et al.
        Risk of cesarean after induction of labor in twin compared to singleton pregnancies.
        Eur J Obstet Gynecol Reprod Biol. 2019; 237: 68-73
        • Jain V.
        • O'Quinn C.
        • Van den Hof M.
        Guideline no. 421: point of care ultrasound in obstetrics and gynaecology.
        J Obstet Gynaecol Can. 2021; 43: 1094-1099.e1091
        • Leduc D.
        • Senikas V.
        • Lalonde A.B.
        No. 235-active management of the third stage of labour: prevention and treatment of postpartum hemorrhage.
        J Obstet Gynaecol Can. 2018; 40: e841-e855
        • McDonald S.D.
        • Narvey M.
        • Ehman W.
        • et al.
        Guideline no. 424: umbilical cord managmeent in pretern and term infants.
        J Obstet Gynaecol Can. 2022; 44: 313-322
        • Kent E.M.
        • Breathnach F.M.
        • Gillan J.E.
        • et al.
        Placental pathology, birthweight discordance, and growth restriction in twin pregnancy: results of the ESPRiT Study.
        Am J Obstet Gynecol. 2012; 207: 220.e221-220.e225

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