Document Detail

ACR Appropriateness Criteria® Multiple Gestations.
MedLine Citation:
PMID:  22634795     Owner:  NLM     Status:  Publisher    
ABSTRACT: Multiple gestations are high-risk compared with singleton pregnancies. Prematurity and intrauterine growth restrictions are the major sources of morbidity and mortality common to all twin gestations. Monochorionic twins are at a higher risk for twin-twin transfusion, fetal growth restriction, congenital anomalies, vasa previa, velamentous insertion of the umbilical cord and fetal death. Therefore, determination of multiple gestation, amnionicity and chorionicity in the first trimester is important. Follow up examinations to evaluate fetal well-being include assessment of fetal growth and amniotic fluid volume, umbilical artery Doppler, nonstress test and biophysical profile. To date, there is a paucity of literature regarding imaging schedules for follow-up. At the very least, antepartum testing in multiple gestations is recommended in all situations in which surveillance would ordinarily be performed in a singleton pregnancy.The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed biennially by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging.
Sandra O Dejesus Allison; Marcia C Javitt; Phyllis Glanc; Rochelle F Andreotti; Genevieve L Bennett; Douglas L Brown; Theodore Dubinsky; Mukesh G Harisinghani; Robert D Harris; Donald G Mitchell; Pari V Pandharipande; Harpreet K Pannu; Ann E Podrasky; Thomas D Shipp; Cary Lynn Siegel; Lynn Simpson; Jade J Wong-You-Cheong; Carolyn M Zelop
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Publication Detail:
Journal Detail:
Title:  Ultrasound quarterly     Volume:  28     ISSN:  1536-0253     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-5-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8809459     Medline TA:  Ultrasound Q     Country:  -    
Other Details:
Languages:  ENG     Pagination:  149-155     Citation Subset:  -    
*Georgetown University Hospital, Washington, District of Columbia; †Walter Reed Army Medical Center, Washington, District of Columbia; ‡Sunnybrook Health Sciences Centre, Bayview Campus, Toronto, Ontario, Canada; §Vanderbilt University Medical Center, Nashville, Tennessee; ∥New York University Medical Center, New York, New York; ¶Mayo Clinic, Rochester, Minnesota; #University of Washington School of Medicine, Seattle, Washington; **Massachusetts General Hospital, Boston Massachusetts; ††Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; ‡‡Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; §§Massachusetts General Hospital, Boston Massachusetts; ∥∥Memorial Sloan Kettering Cancer Center, New York, New York; ¶¶Baptist Hospital of Miami/South Miami Center for Women and Infants, Miami, Florida; ##Diagnostic Ultrasound Associates, Boston, Massachusetts, American College of Obstetrics and Gynecology; ***Mallinckrodt Institute of Radiology, St. Louis, Missouri; †††Columbia University, New York, New York, American College of Obstetrics and Gynecology; ‡‡‡University of Maryland School of Medicine, Baltimore, Maryland; and §§§Beth Israel Deaconess Medical Center, Harvard University School of Medicine, Boston, Massachusetts, American College of Obstetrics and Gynecology.
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