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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2017

Open Access 01-12-2017 | Research article

Multidisciplinary consensus on screening for, diagnosis and management of fetal growth restriction in the Netherlands

Authors: Viki Verfaille, Ank de Jonge, Lidwine Mokkink, Myrte Westerneng, Henriëtte van der Horst, Petra Jellema, Arie Franx, IRIS study group

Published in: BMC Pregnancy and Childbirth | Issue 1/2017

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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

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Metadata
Title
Multidisciplinary consensus on screening for, diagnosis and management of fetal growth restriction in the Netherlands
Authors
Viki Verfaille
Ank de Jonge
Lidwine Mokkink
Myrte Westerneng
Henriëtte van der Horst
Petra Jellema
Arie Franx
IRIS study group
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2017
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-017-1513-3

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