13 August 2020

Twins Trust has welcomed the publication of a report that looks at the possibility of assessing the current level of care for multiple birth babies using data that is currently collected by the NHS.

The National Maternity and Perinatal Audit (NMPA) looked at data from births between April 2015 and March 2017 in England, Wales and Scotland. Twins Trust was asked to be expert advisors to the report and our work was quoted throughout.

Newborn twins

Recommendations from the report would mean more hospitals follow NICE guidelines which would mean improved care for our families – something we can help with through our Maternity Engagement quality improvement project.

Worryingly, however, it showed that data collected for singletons vs multiples is superior highlighting the need for data to be recorded correctly for families with twins, triplets or more.

Therefore, currently, there is not a true picture of multiple maternity care currently being provided due to data being poor – particularly among neonatal care and TTTS treatment.

There is a recommendation that maternity service providers put systems in place by the end of the 2020/21 reporting year to

  • Record data on number of fetuses in the first trimester in addition to the number at birth.
  • Ensure chorionicity and amnionicity are a compulsory data item.
  • Those who offer specialist fetal procedures, such as laser therapy, should work with coding departments to ensure fetal complications and procedures are properly coded.
  • Record mode of birth accurately – urgent c-section as opposed to planned.
  • NHS numbers of babies is linked to the mother and not the baby record of the other twin.

Keith Reed, CEO of Twins Trust said: “Without good data we cannot get an accurate picture of what maternity care is like for our families.

“What it has shown is that our families are still being split up if neonatal beds are not available at the same hospital, and that data on c-sections, whether the procedure was planned or an emergency, is poor.

“The audit was not able to assess provision of specialist services for twin babies with fetal complications such as TTTS because these diagnoses and related therapeutic procedures were poorly recorded.

“We are currently building our own TTTS registry which should provide good quality data on procedures and outcomes which can be learned from. It’s amazing 80 families have taken part on our walk 10k for TTTS to support the costs of this resource just in August alone.

“We are pressing for future national data sources to collect the key points highlighted in this report.

“We are continuing to press local maternity units to review their care to make sure it is as good as possible and offering up practical help to make changes if needed.”

The audit was led by the Royal College of Obstetricians and Gynaecologists (RCOG) in partnership with the Royal College of Midwives (RCM), the Royal College of Paediatrics and Child Health (RCPCH) and the London School of Hygiene and Tropical Medicine (LSHTM).

Twins Trust was one of the advisors on the report.

You can view the report here.