ACR Appropriateness Criteria ® Multiple Gestations
| Autor: | Therese M. Weber, Liina Poder, Lynn L. Simpson, David A. Nyberg, Nadia J. Khati, Carolyn M. Zelop, Phyllis Glanc, Thomas D. Shipp, Sandeep Deshmukh, Kika M. Dudiak, Tara L. Henrichsen |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
030219 obstetrics & reproductive medicine Obstetrics business.industry Vasa Previa Intrauterine growth restriction medicine.disease Appropriate Use Criteria Placenta previa 03 medical and health sciences 0302 clinical medicine Velamentous cord insertion medicine Gestation Radiology Nuclear Medicine and imaging 030212 general & internal medicine Monochorionic twins business Twin Pregnancy |
| Zdroj: | Journal of the American College of Radiology. 14:S476-S489 |
| ISSN: | 1546-1440 |
| DOI: | 10.1016/j.jacr.2017.08.051 |
| Popis: | Women with twin or higher-order pregnancies will typically have more ultrasound examinations than women with a singleton pregnancy. Most women will have at minimum a first trimester scan, a nuchal translucency evaluation scan, fetal anatomy scan at 18 to 22 weeks, and one or more scans in the third trimester to evaluate growth. Multiple gestations are at higher risk for preterm delivery, congenital anomalies, fetal growth restriction, placenta previa, vasa previa, and velamentous cord insertion. Chorionicity and amnionicity should be determined as early as possible when a twin pregnancy is identified to permit triage of the monochorionic group into a closer surveillance model. Screening for congenital heart disease is warranted in monochorionic twins because they have an increased rate of congenital cardiac anomalies. In addition, monochorionic twins have a higher risk of developing cardiac abnormalities in later gestation related to right ventricular outflow obstruction, in particular the subgroups with twin-twin transfusion syndrome or selective intrauterine growth restriction. Monochorionic twins have unique complications including twin-to-twin transfusion syndrome, twin embolization syndrome, and acardius, or twin-reversed arterial perfusion sequence. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. |
| Databáze: | OpenAIRE |
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