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Physios should be part of team supporting women pregnant with twins or triplets

NICE guidelines recommend a women's health physiotherapist is part of an enhanced team supporting pregnant women

Published on 11th September 2019

Physiotherapists should be part of a specialist team supporting women pregnant with twins or triplets during antenatal care, according to guidelines from the National Institute for Health and Care Excellence.

Antenatal clinical care for women with a twin or triplet pregnancy should be provided by a nominated multidisciplinary team consisting of a core team of named specialist obstetricians, specialist midwives and sonographers, all of whom have experience and knowledge of managing twin and triplet pregnancies.

An enhanced team for referrals should be on hand including a perinatal mental health professional, a women's health physiotherapist, an infant feeding specialist and a dietitian, the NICE guidelines says.

Katie Mann, chair of the professional network Pelvic, Obstetric and Gynaecological Physiotherapy (POGP), said: "We are very pleased to see physiotherapy again being recognised in the core multidisciplinary workforce for pregnant women, and also supporting pregnant women with a twin or triplet pregnancy.

"Specialist women’s health physiotherapists should be central to all care of the pregnant woman regardless of the number of babies, the progression of pregnancy or the mode of delivery," she added.

Members of the enhanced team should have experience and knowledge relevant to twin and triplet pregnancies, the guidance adds.

All women with a twin or triplet pregnancy should not be routinely referred to the enhanced team but professionals should base the decision to refer on each woman's needs.

The core team of obstetricians, specialist midwives and sonographers should provide information and emotional support specific to twin and triplet pregnancies at their first contact with the woman and provide ongoing opportunities for further discussion and advice including:

- antenatal and postnatal mental health and wellbeing

- antenatal nutrition

- the risks, symptoms and signs of preterm labour and the potential need for corticosteroids for fetal lung maturation

- likely timing of birth and possible modes of birth

- breastfeeding

- parenting.

Clinical care for women pregnant with twins or triplets should be co-ordinated to minimise the number of hospital visits, provide care as close to the woman's home as possible and provide continuity of care within and between hospitals and the community.

NICE guidelines on twin and triplet pregnancy

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