Guest article by Stephanie Ernst, Founder and Director of The TAPS Support Foundation, and Professor Asma Khalil, Consultant Obstetrician and Fetal Medicine specialist at St George’s Hospital, London.

The ISUOG Practice Guidelines have long been an important resource for healthcare professionals managing twin pregnancies. However, their technical nature can be difficult for expectant parents to fully understand. To address this gap, the Patient Guide to Twin Pregnancy Screening was created by Stephanie Ernst and Prof. Asma Khalil. This guide helps parents understand the screening, monitoring and treatment they may need, why these matter, and how they can improve safety, all in clear, easy-to-understand language.

Why the guide was created

The ISUOG Patient Guide to Twin Pregnancy was created by Stephanie Ernst and Prof. Asma Khalil to address the unique challenges faced by families navigating twin pregnancies. Twin pregnancies often involve complex risks, such as twin-to-twin transfusion syndrome (TTTS) and selective fetal growth restriction (sFGR), and the healthcare system has shown inequalities in managing these conditions, which can result in poorer outcomes compared to singleton pregnancies. This guide was developed to bridge this gap by providing parents with clear, accessible information that helps them understand the necessary medical care and the role of ultrasound in monitoring their pregnancy.

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The guide ensures that parents are informed about key steps, like determining chorionicity early to assess shared placental conditions, and how these steps contribute to better outcomes. By offering a clear explanation of the screening processes, it helps to demystify complex medical concepts, ensuring that parents feel empowered to make informed decisions with their healthcare providers.

A key aspect of this guide is its appraisal of internationally recognized research and best practices for managing twin pregnancies. While the guide doesn’t provide the evidence-based practices themselves, it translates the ISUOG best practice guideline into accessible language for parents. By doing so, it ensures that families worldwide can better understand the monitoring and care needed for twin pregnancies. The guide aims to enhance awareness and support by making complex medical information clear, fostering inclusivity, and helping families navigate the unique challenges of twin pregnancies with confidence.

Unique aspects of twin pregnancies

Twin pregnancies come with special challenges, such as risks like twin-to-twin transfusion syndrome (TTTS) and selective fetal growth restriction (sFGR), which require careful monitoring. The ISUOG guideline explains the best practices for managing these conditions. However, for many parents, the reasons behind frequent ultrasounds or why it’s important to check certain details early in pregnancy may not be clear. This guide translates these steps into everyday language, helping parents take an active role in their care and make informed decisions with their healthcare providers.

The guide doesn’t just simplify medical terms; it also stresses the importance of following well-researched, proven methods. Guidelines for managing twin pregnancies can differ across countries, but the ISUOG guideline offers a trusted standard of care, based on research and expert recommendations. By putting this information in clear language, the guide helps ensure that care is consistent and builds trust between parents and their doctors.

Supporting parents through patient-centred care

At the heart of this guide is a focus on patient-centered care. Parents should know why certain tests or steps are important, such as checking early for chorionicity (whether the twins share a placenta) to identify risks. When parents understand the purpose behind these measures, they feel more confident and supported in their pregnancy journey. The guide also helps parents understand what “risk” means. In this context, risk doesn’t mean a problem is certain, but points to areas that need extra care. For example, checking for chorionicity early helps identify whether the twins share a placenta, which could increase the chance of complications like TTTS. Regular ultrasound scans help doctors act quickly if needed, reducing harm. The guide also explains how screening tests like non-invasive prenatal testing (NIPT) can check for chromosomal issues affecting the babies, giving parents reassurance or pointing to next steps. By explaining these processes, the guide shows that monitoring risks is part of a safe and proactive approach to care, not something to fear.

This patient guide is a vital step in helping parents feel more involved in their pregnancy care. By explaining why certain tests and procedures are necessary, it helps parents feel confident and informed. With guides like this, parents can work closely with their healthcare teams to manage the challenges of twin pregnancies and feel supported throughout their journey.

Download the guide here.