Background: Incidence of twin pregnancy is increasing all over the world. It can occur after Assisted Reproductive Technology (ART) or spontaneously and associated with increased maternal and neonatal complications both in the developed and developing countries.Methods: A descriptive (Cross sectional) study of 64 cases of twins was undertaken between January 2013 till December 2015. Data collection was done prospectively from the patients admitted to the hospital with twin gestation. Inclusion criteria: All pregnancy with twin gestation more than 28 weeks of gestation. Twin pregnancies with both fetuses alive are included. Exclusion criteria is multiple gestation other than twins, cases with congenital malformation and intrauterine death (in one or both twins) were excluded. Data included thorough antenatal history, demographic details and intrapartum and postpartum maternal and neonatal details.Results: Prevalence of twins in our study was 1.61% (95% CI 1.3-2%). Out of 69 cases of twin pregnancy 64 cases fulfilled the inclusion criteria. History of ovulation induction was associated with 23% cases. Commonest complications observed were preterm labour (56.5%) anaemia (43.4%) and PIH (22.3%). 30.2% cases delivered vaginally whereas 69.8% patients required c. section, malpresentation being commonest indication. No intrapartum still birth was recorded. Early neonatal death was seen in eight cases, causes were prematurity, hyaline membrane disease and neonatal jaundice. Diamnoitic-dichorionic twins were 90% and 3% cases were monoamniotic monochorionic. Zygosity was calculated by Weinbergs formula and 84% cases were dizygotic while 16% cases were monozygotic. No maternal mortality related to twin pregnancy was reported in present study.Conclusions: All twin pregnancy should be considered as high risk pregnancies and should have mandatory hospital delivery. Early diagnosis, adequate antenatal, intrapartum and postpartum care as well as good NICU back up are the key factors in reducing the complications and improving the perinatal outcome in twin pregnancies.

Background: The birth of a newborn after twenty-eight completed weeks of gestation weighing 1,000 gm or more, with baby showing no signs of life after delivery is a still born’’. Such death includes both antepartum and intrapartum death. Stillbirths (SB) are the largest contributor to perinatal mortality. Of the estimated 3 million stillbirths which occur yearly, the vast majority are in developing countries, with rates in many developing countries ten-fold higher than elsewhere.Methods: Descriptive (cross sectional) study was conducted at tertiary referral hospital in rural area of Maharashtra from September 2015 to August 2017. Out of total 3235 deliveries during study period 64 mothers giving birth to 66 cases of still birth (2 cases of twins) satisfied the inclusion criteria and studied to find out prevalence, causes and high-risk factor association with stillbirth.Results: Stillbirth rate in our study was 20.4/1000 deliveries. 56.25% patients were in the 21-25 years age group.9.3% were illiterate while 57.81% had education below 12th standard. Most patients were from low socioeconomic status and 57.81% were unregistered. Stillbirth was more common in Para (2-4), premature baby and with male sex preponderance in our study. Most patients 90.62% were delivered vaginally. Preeclmpsia, Abruption, Anaemia were common high-risk factor associated with stillbirth.54.6% cases were unexplained stillbirth while IUGR was noted in 23.4% cases and other causes noted were prematurity, congenital anomaly, cord and placental causes were found in our study.Conclusions: A significant proportion of stillbirths are preventable by adequate antenatal care. Female literacy and health education, adequate antenatal care, identification of high-risk cases, and timely referral needs to be emphasized among the medical and paramedical personnel at the first point of contact with the pregnant women.