Outcomes in intervention and management of multiple pregnancies trials: A systematic review

ObjectivesTwin pregnancy has risks of adverse outcomes for mother and baby. Data synthesis is required to gain evidence aid recommendations but may be hampered by variations in outcome reporting.Study designSystematically review reported twin trials (PROSPERO - CRD42019133805). Searches were performed MEDLINE, EMBASE, CINHAL, Cochrane library (inception-January 2019) randomised control or their follow-up studies reporting prediction, prognosis, intervention management pregnancy. The study characteristics, definitions measurements extracted descriptively analysed.Results49 RCTs 8 evaluated 21 interventions, 1257 outcomes, categorised into 170 unique outcomes. 65 % included all pregnancies, 12 DCDA 11 MCDA only MCMA MCDA. Five (9 %) papers prediction/ prognosis RCT’s 52 (91 related an intervention. Of 40 (77 medical, 34 (85 preterm birth; (23 surgical, 6 (50 TTTS interventions (83 monochrorionic studies). Commonest domains were: ‘Neonatal’ 77 %, ‘Delivery’ 70 ‘Survival’ 67 %. Least longer term ‘Infant’ ‘Parental’.ConclusionsTwin are diverse complex. This the need address maternal, single double fetal different types chorionicity. lack standardisation selection, definition hinders selection important women health care professionals thus limiting effectiveness research.