Study of obstetric and fetal outcome of twin pregnancy in a tertiary care centre

Abstract

Background:The past two decades have witnessed a sharp rise in the incidence of twin and higher order gestations. The progress and developments in assisted reproductive technology, availability and widespread use of ovulation inducing drugs and delayed childbearing are thought to be the causes responsible for the rise. Twin pregnancy is associated with increased maternal and perinatal morbidity and mortality as well as healthcare costs. Maternal complications like hypertensive disorders, anemia, gestational diabetes mellitus (GDM), preterm labour, preterm premature rupture of membranes (PPROM) and placental abruption increases. It is also responsible for repeated antenatal admissions, longer hospital stay, blood transfusions and increase in operative vaginal or cesarean delivery, post-partum hemorrhage and Hysterectomy. Twins have an increased risk of intraventricular hemorrhage, sepsis, necrotizing enterocolitis, respiratory distress syndrome and neonatal death. The objective of the study was to study the maternal and fetal outcome of twin pregnancy. Methods: Retrospective analytical review of all twin deliveries at the teaching hospital medical college of Central India, over a period of 3 years between January 2010 and December 2012.There were 55 twin deliveries, data analysis regarding maternal age, parity, presentation, gestational age at delivery, obstetric complication mode of delivery, birth weights, and perinatal morbidity & mortality was analyzed. Results: Majority of patients 44 (80%) were in age group of 20-30 years. 55% patients were booked and 62% were from urban area. 18 (32%) patients could reach beyond 37 weeks, there were 21 (38%) cases between 34 to 37 weeks and 16 (29%) between 30 to 34 weeks of gestation. Preterm delivery was the commonest complication occurring in 67% of the cases. Cephalic presentation of both the babies occurred in 36% of the cases. 50% of the twins needed admission to NICU for various indications like prematurity, birth asphyxia, low birth weight, meconium staining of liquor & delivery by caesarean section. In our study among the 55 twin births there were 16 (29 %) perinatal deaths and one maternal mortality. Conclusions: Twin pregnancies are high risk pregnancies with more maternal and fetal complications. The use of antenatal care services, identification and anticipation of complications, intrapartum management and good NICU facilities will help to improve maternal and neonatal outcome in twin pregnancies.

A clinical study on maternal and fetal outcome in twin pregnancy at KIMS hospital, Hubli, Karnataka, India

“…7 Important indications were fetal malpresentations and prev lscs which were the same indications in majority of the studies coated. 2,7 The mean birth weight of first twin was 1.8kg and second twin was 1.6kg which were similar to the studies done by Gurupreet Kaur et al, Chaudhary et al and Jacques Milliez MD et al [8][9][10] The low birth weight in the present study could be due to nutritional factors, low socioeconomic factors and increased prevalence of preterm labour.…”

Maternal complications in twin pregnancy; recent trends: a study at a tertiary care referral institute in Northern India

“…Deepthi et al and Nandmer G et al reported preterm delivery in 60% and 67% of twin pregnancies respectively. 14,17 Whereas, Shetty MB et al and Chowdhury et al reported much lower incidence of preterm delivery in 38% and 44% of patients respectively. 18,19 The inherited risk of preterm delivery in multiple pregnancies is supported by higher incidence of preterm delivery in this study, out of 304 (70%) preterm delivery 272 (89.4% had spontaneous preterm labor and 32 (10.5%) were induced preterm delivery.…”

Maternal and neonatal outcome of twin pregnancy at a tertiary care center

“…Studies have reported cesarean section (LSCS) in 68%, 49% and 45% where as our study reports it as 92%. [27][28][29][30][31] In our study most common mode of delivery is LSCS , few studies reported that mode of delivery is a significant predictor of perinatal outcome , however this predictor is not quite conclusive, as conflicting results are published in other few studies. 31,32 Pregnancy induced hypertension(PIH) was observed in 32% twin pregnancy in our study which was similar to study published earlier which reported 40 % PIH.…”