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Twin and Multiple Pregnancy - Part 1

St George’s Hospital, University of London

Faculty at St George’s Hospital, University of London

Main Areas of Interest

Lecturing and Teaching:

This fellowship is designed for physicians and sonographers who look after women with twin and multiple pregnancies. Twin pregnancy, which is becoming more common, is associated with increased maternal and perinatal mortality and morbidity. Offering a practical guide and a wealth of videos, images and illustrations, the fellowship will help clinicians to feel more confident when caring for women with twin pregnancy.

Its main objectives are:

To increase the level of knowledge of healthcare professionals involved in the care of these women;
To update their knowledge in keeping with the recommendations of the latest national and international guidelines; and
To promote a multidisciplinary approach to the management of women with multiple pregnancy.

Specialties

Obstetrics

Gynecology

Techniques You Will Learn

Learning Outcomes:

Obtain fundamental knowledge in keeping with the recommendations of the latest national and international guidelines
Critically apply their understanding to different scenarios including complicated monochorionic twin pregnancy, such twin to twin transfusion syndrome, selective fetal growth restriction, twin anaemia polycythaemia sequence and twin reversed arterial perfusion
Promote a multidisciplinary approach to the management of women with multiple pregnancy

Learning and Teaching Resources: (any articles or textbooks that you recommend)

RCOG Monochorionic twin guideline

https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.14188

NICE twin and triplet guideline

https://www.nice.org.uk/guidance/ng137/chapter/Recommendations

ISUOG twin guideline

https://www.isuog.org/uploads/assets/uploaded/b4ce0129-a7e8-40a9-8543c4243fb7638f.pdf

FIGO twin guideline

https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.12742

AJOG (SMFM) TTTS guideline

https://www.ajog.org/article/S0002-9378(12)01980-1/pdf

Twin growth chart

https://www.ncbi.nlm.nih.gov/pubmed/29660172, https://www.ncbi.nlm.nih.gov/pubmed/27622538, https://www.ncbi.nlm.nih.gov/pubmed/25052857

Twin PSP

https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1002/uog.20858

A core outcome set for studies investigating the management of selective fetal growth restriction in twins

https://www.ncbi.nlm.nih.gov/pubmed/31273879

Modules

Tasks and Timeline:

Module 1 (Week 1) National and International guidelines on Twin and Multiple Pregnancy

This course aims to update their knowledge in keeping with the recommendations of the latest national and international guidelines

Module 2 (Week 2) Screening for aneuploidy: roles for ultrasound and NIPT

In this course, we will learn the various available screening tests for see aneuploidy in twin and multiple pregnancy, their performance and limitations

Module 3 (Week 3) Fetal abnormalities in multiple pregnancy

In this course, we will learn the common structural abnormalities in twin pregnancies and their management. We will also discuss various interesting and challenging cases and their management.

Module 4 (Week 4) Monochorionic monoamniotic twin pregnancies: tips for diagnosis and surveillance

Monochorionic monoamniotic twin pregnancy is rare and at particularly higher risk of pregnancy loss, perinatal mortality and morbidity. In this course, we will learn the complications specific to monochorionic monoamniotic twin pregnancy, surveillance options, challenges and current best management.

Module 5 (Week 5) Reduction in multiple pregnancies: counselling and techniques

Reduction of triplet pregnancy to twins or singleton is associated with reduction in the risk of preterm birth and cerebral palsy. However, it is associated with the risk of miscarriage. In this course, we will learn how to counsel the parents in the various types of triplet pregnancies and the techniques used.

Module 6 (Week 6) Discordance in twin pregnancy: a benign or ominous sign?

Discordance is common in twin pregnancy. Discordance can be in the size, amniotic fluid volume or fetal Dopplers. In this course, we will learn how to counsel, monitor and manage twin pregnancy with discordance in size, amniotic fluid volume or fetal Dopplers.

Program Fee


Total Number of Modules	6
Time duration of Each module	45 minutes
Total Program Cost	$675

This program allows Merit Applications. This program allows merit-based applications for virtual and onsite clinical and research programs. If you are successfully awarded under this category, Trialect or the host mentor will cover the tuition fee only. All applications will be evaluated based on merit. Due to the high level of competition, the chances of being selected under the merit category are quite limited.

Who Can Apply

Physicians and other healthcare professionals who critically apply their understanding to different scenarios including complicated monochorionic twin pregnancy, such twin to twin transfusion syndrome, selective fetal growth restriction, twin anaemia poly

Host Details

Host Name: Professor Asma Khalil

Affiliation: St George’s Hospital, University of London

Address: 78 Harley Street, London W1G 7HJ

Website URL: http://www.asmakhalil.co.uk/

Disclaimer:It is mandatory that all applicants carry workplace liability insurance, e.g., https://www.protrip-world-liability.com (Erasmus students use this package and typically costs around 5 € per month - please check) in addition to health insurance when you join any of the onsite Trialect partnered fellowships.