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dc.contributor.authorWu, Su-Wen
dc.contributor.authorZhou, Qiongjie
dc.contributor.authorXiao, Xirong
dc.contributor.authorXiong, Yu
dc.contributor.authorLiang, Huan
dc.contributor.authorShen, Jie
dc.contributor.authorBarrett, Jon
dc.contributor.authorWang, Hong
dc.contributor.authorLi, Xiao-Tian
dc.date.accessioned2022-06-30T08:12:53Z
dc.date.available2022-06-30T08:12:53Z
dc.date.issued2020-04-02
dc.description.abstractObjective: Ultrasound determination of chorionicity is poor in early pregnancy in China. In an effort to increase the accuracy rate of prompt chorionicity determination, clinical training was provided to primary care physicians. This study assesses the effects of implementing clinical guidelines on chorionicity determination.<p> <p>Methods: A multi‑centered cohort study was conducted between January 2014 and June 2017 in 12 hospitals without fetal medicine centers. In 2014, the obstetricians and ultrasound physicians were trained in clinical practice and ultrasound examination relating to chorionicity determination. Linear and binary regression analyses were conducted to identify the effects of introducing the new protocols, including the diagnosis rate of chorionicty and perinatal outcomes, taking the data from 2014 as a baseline. Pregnancy outcomes were additionally adjusted for maternal age. <p>Results: During the period of this study, 3,599 twin pregnancies from 12 centers were enrolled, and a total of 2,998 twin pregnancies were extracted. The rate of overall chorionicity determination, including antenatal and postpartum diagnosis, increased successively from 49.5% in 2014 to 93.5% in 2017 (P < 0.0001). The rate of ultrasonic chorionicity diagnosis before 14 weeks increased from 25.2% in 2014 to 65.0% in 2017 (P < 0.0001). These changes were associated with decreasing incidence of preterm birth, a lower risk of stillbirth, whether for one (P = 0.0456 in 2016) or two fetuses (P = 0.0470 in 2016; P = 0.0042 in 2017) and a decreased rate of admission to neonatal intensive care unit (43.0% in 2014, 37.4% in 2017; P = 0.0032). <p>Conclusions: The implementation of a clinical practice guideline improved both overall and early chorionicity determinations. Regular training workshops of antenatal care are recommended to further promote capability in clinical diagnosis and treatment.en_US
dc.identifier.citationWu, Zhou, Xiao, Xiong, Liang, Shen, Barrett, Wang, Li. Implementation of international society guidelines on chorionicity determination in twins: A multi-Center cohort study in mainland China. Reproductive and Developmental Medicine. 2020;4(1):42-52en_US
dc.identifier.cristinIDFRIDAID 1890079
dc.identifier.doi10.4103/2096-2924.281857
dc.identifier.issn2096-2924
dc.identifier.issn2589-8728
dc.identifier.urihttps://hdl.handle.net/10037/25660
dc.language.isoengen_US
dc.publisherWolters Kluweren_US
dc.relation.journalReproductive and Developmental Medicine
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2020 Reproductive and Developmental Medicineen_US
dc.titleImplementation of international society guidelines on chorionicity determination in twins: A multi-Center cohort study in mainland Chinaen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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