TY - JOUR
T1 - Multidisciplinary consensus on screening for, diagnosis and management of fetal growth restriction in the Netherlands
AU - Verfaille, Viki
AU - de Jonge, Ank
AU - Mokkink, Lidwine
AU - Westerneng, Myrte
AU - van der Horst, Henriëtte
AU - Jellema, Petra
AU - Franx, Arie
AU - Bais, Joke M J
AU - Bonsel, Gouke J.
AU - Bosmans, Judith E
AU - van Dillen, Jeroen
AU - van Duijnhoven, Noortje T L
AU - Grobman, William A.
AU - Groen, Henk
AU - Hukkelhoven, Chantal W P M
AU - Klomp, Trudy
AU - Kok, Marjolein
AU - de Kroon, Marlou L.
AU - Kruijt, Maya
AU - Kwee, Anneke
AU - Ledda, Sabina
AU - Lafeber, Harry N.
AU - van Lith, Jan M
AU - Mol, Ben Willem
AU - Molewijk, Bert
AU - Nieuwenhuijze, Marianne
AU - Oei, Guid
AU - Oudejans, Cees
AU - Paarlberg, K. Marieke
AU - Pajkrt, Eva
AU - Papageorghiou, Aris T.
AU - Reddy, Uma M.
AU - de Reu, Paul A O M
AU - Rijnders, Marlies E. B.
AU - de Roon-Immerzeel, Alieke
AU - Scheele, Connie
AU - Scherjon, Sicco A
AU - Snijders, Rosalinde
AU - Teunissen, Pim W.
AU - Torij, Hanneke W.
AU - Twisk, Jos Wr
AU - Zeeman, Kristel C.
AU - Zhang, Jun
N1 - Funding Information:
The IRIS study received funding from the Netherlands Organization for Health Research and Development (ZonMw) in the context of the research program Pregnancy and Childbirth, grant number: 209,030,001. ZonMw was not involved in the design of the study and collection, analysis, and interpretation of data and in writing this manuscript.
Publisher Copyright:
© 2017 The Author(s).
PY - 2017/10/16
Y1 - 2017/10/16
N2 - Background: Screening 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. Methods: We 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. Results: Per 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. Conclusions: We 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 registration:NTR4367.
AB - Background: Screening 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. Methods: We 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. Results: Per 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. Conclusions: We 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 registration:NTR4367.
KW - Collaboration
KW - Delphi technique
KW - Fetal growth restriction
KW - Intrauterine growth restriction
KW - Practice guideline
KW - Prenatal ultrasonography
KW - Uniform approach
KW - Humans
KW - Intersectoral Collaboration
KW - Pregnancy Trimester, Third
KW - Consensus
KW - Pregnancy
KW - Interdisciplinary Communication
KW - Netherlands
KW - Delphi Technique
KW - Fetal Growth Retardation/diagnosis
KW - Female
KW - Practice Guidelines as Topic/standards
KW - Prenatal Care/methods
KW - Ultrasonography, Prenatal/methods
KW - fetal growth restriction
UR - http://www.scopus.com/inward/record.url?scp=85031507749&partnerID=8YFLogxK
U2 - 10.1186/s12884-017-1513-3
DO - 10.1186/s12884-017-1513-3
M3 - Article
C2 - 29037170
AN - SCOPUS:85031507749
SN - 1471-2393
VL - 17
SP - 353
EP - 369
JO - BMC Pregnancy and Childbirth [E]
JF - BMC Pregnancy and Childbirth [E]
IS - 1
ER -