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Contact the study team using the details below to take part. If there are no contact details below please ask your doctor in the first instance.
Prof
Asma
Khalil
+44 (0)7917400164
Asma.Khalil@stgeorges.nhs.uk
Mrs
Tracey
Ricketts
+44 (0)1517959562
ricketts@liverpool.ac.uk
Prof
Asma
Khalil
+44 (0)7917400164
Asma.Khalil@stgeorges.nhs.uk
More information about this study, what is involved and how to take part can be found on the study website.
Monochorionic (MC) twin pregnancies with early-onset (prior to 24 weeks) selective fetal growth restriction (sFGR)
This information is provided directly by researchers and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information.
The UK has approximately 11,000 twin pregnancies per year with a third of these sharing a placenta (the afterbirth), called monochorionic (MC) twins. MC twin pregnancy poses extra risks to both the mother and her babies, with some babies dying during pregnancy or shortly after birth. Often this can be due to complications of MC twin pregnancy such as selective fetal growth restriction (sFGR) where one twin is smaller than the other or twin-to-twin transfusion syndrome. sFGR affects one in seven MC twin pregnancies in the UK although less is known about pregnancies where this happens early (before 24 weeks of pregnancy). sFGR in MC twins poses some unique risks; if the smaller twin dies, its death may harm the other twin, causing either death or brain damage. There are three main ways of managing twin pregnancies with sFGR. Firstly, a watch-and-wait approach (also called expectant management). The difficulty with this approach is that the smaller twin could die in the womb, which can lead to death or brain damage to the other twin. Secondly, a procedure can be performed which blocks the umbilical cord from the smaller twin to the placenta and as a consequence, the smaller twin dies (also known as selective termination). This allows the larger twin to continue growing and gain maturity, hopefully delivering at a normal gestation. Finally, a laser can be used to completely separate the twins’ circulations. This method protects the larger twin in the event of the death of the smaller twin but increases the risk of losing the smaller twin. There is no good evidence on the best way of managing sFGR in twin pregnancies, so women and their partners are offered different management options depending on where they live and who they see. It is also clear that there are gaps in what is known about sFGR. A UK national registry of complicated twin pregnancies has already been set up to collect information about pregnancy outcomes. However, there is an urgent need for more research to see if a study comparing different management options is possible. Before running such a study, understanding is needed about things like how many twin pregnancies would be needed to run the study and whether women and clinicians would be willing to take part. Which management options will work best and what outcomes are important also need to be researched.
Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.
The recruitment start and end dates are as follows:
2024 Protocol article in https://pubmed.ncbi.nlm.nih.gov/39153765/ (added 09/09/2024)2024 Other publications in https://pubmed.ncbi.nlm.nih.gov/39122401/ (added 10/09/2024)2024 Other publications in https://pubmed.ncbi.nlm.nih.gov/38956742/ (added 10/09/2024)2024 Other publications in https://pubmed.ncbi.nlm.nih.gov/38379063/ (added 10/09/2024)
You can take part if:
You may not be able to take part if:
1. Singleton pregnancies2. Maternal age under 18 years3. TTTS4. Twin anaemia polycythaemia sequence before enrolment5. Other rare complicated MC twin pregnancies, such as twin reversed arterial perfusion syndrome6. Known karyotype abnormality at enrolment7. Known major fetal structural abnormality at enrolment, defined as a lethal, incurable or curable severe abnormality with a high risk of residual handicap8. Indication for immediate delivery9. Pre-term pre-labour rupture of membranes before enrolment10. Women who lack the capacity to give informed consent11. Any medical condition that compromises the woman’s ability to participate
Below are the locations for where you can take part in the trial. Please note that not all sites may be open.
Prof
Asma
Khalil
+44 (0)7917400164
Asma.Khalil@stgeorges.nhs.uk
Prof
Asma
Khalil
+44 (0)7917400164
Asma.Khalil@stgeorges.nhs.uk
Mrs
Tracey
Ricketts
+44 (0)1517959562
ricketts@liverpool.ac.uk
More information about this study, what is involved and how to take part can be found on the study website.
The study is sponsored by University of Liverpool and funded by NIHR HTA.
Your feedback is important to us. It will help us improve the quality of the study information on this site. Please answer both questions.
Or CPMS 47201
You can print or share the study information with your GP/healthcare provider or contact the research team directly.
