Abstract

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.

Original languageEnglish
Article number353
JournalBMC Pregnancy and Childbirth
Volume17
Issue number1
DOIs
Publication statusPublished - 16 Oct 2017

Cite this

@article{7412129c2c434a80ae9b9bf5ae39793b,
title = "Multidisciplinary consensus on screening for, diagnosis and management of fetal growth restriction in the Netherlands",
abstract = "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.",
keywords = "Collaboration, Delphi technique, Fetal growth restriction, Intrauterine growth restriction, Practice guideline, Prenatal ultrasonography, Uniform approach",
author = "Viki Verfaille and {de Jonge}, Ank and Lidwine Mokkink and Myrte Westerneng and {van der Horst}, Henri{\"e}tte and Petra Jellema and Arie Franx and Joke Bais and Bonsel, {Gouke J.} and Bosmans, {Judith E.} and {van Dillen}, Jeroen and {van Duijnhoven}, {Noortje T.L.} and Grobman, {William A.} and Henk Groen and Hukkelhoven, {Chantal W.P.M.} and Trudy Klomp and Marjolein Kok and {de Kroon}, {Marlou L.} and Maya Kruijt and Anneke Kwee and Sabina Ledda and Lafeber, {Harry N.} and {van Lith}, {Jan M.} and Mol, {Ben Willem} and Bert Molewijk and Marianne Nieuwenhuijze and Guid Oei and Cees Oudejans and Paarlberg, {K. Marieke} and Eva Pajkrt and Papageorghiou, {Aris T.} and Reddy, {Uma M.} and {De Reu}, {Paul A.O.M.} and Marlies Rijnders and {de Roon-Immerzeel}, Alieke and Connie Scheele and Scherjon, {Sicco A.} and Rosalinde Snijders and Teunissen, {Pim W.} and Torij, {Hanneke W.} and Jos Twisk and Zeeman, {K. C.} and Jun Zhang and {IRIS study group}",
year = "2017",
month = "10",
day = "16",
doi = "10.1186/s12884-017-1513-3",
language = "English",
volume = "17",
journal = "BMC Pregnancy and Childbirth",
issn = "1471-2393",
publisher = "BioMed Central",
number = "1",

}

Multidisciplinary consensus on screening for, diagnosis and management of fetal growth restriction in the Netherlands. / Verfaille, Viki; de Jonge, Ank; Mokkink, Lidwine; Westerneng, Myrte; van der Horst, Henriëtte; Jellema, Petra; Franx, Arie; IRIS study group.

In: BMC Pregnancy and Childbirth, Vol. 17, No. 1, 353, 16.10.2017.

Research output: Contribution to journalArticleAcademicpeer-review

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

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

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

AU - Zeeman, K. C.

AU - Zhang, Jun

AU - IRIS study group

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

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

VL - 17

JO - BMC Pregnancy and Childbirth

JF - BMC Pregnancy and Childbirth

SN - 1471-2393

IS - 1

M1 - 353

ER -