Fetomaternal outcome in multiple pregnancy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20214446Keywords:
Twin gestation, Maternal, Perinatal, ChorionicityAbstract
Background: Multiple pregnancies are more common in recent days than in the past. Increased maternal age at conception due to delayed childbearing trend has resulted in multifetal gestations. Twin gestation imposes greater demand on the maternal physiological system than does singleton pregnancy. The incidence of multifetal gestation has increased mainly because of advanced maternal age and assisted reproductive technology. Multiple pregnancy is considered as high-risk pregnancy as it contributes significantly to adverse maternal and perinatal outcomes.
Methods: In this prospective observational study conducted in obstetrics and gynaecology department VMKVMCH, Salem for 6 months period, around 50 cases of multiple pregnancy were taken into consideration and patients were followed up from admission till delivery and neonatal outcome analysed. Main outcome measures were maternal complications (anaemia, pre-eclampsia, post-partum hemorrhage, gestational diabetes mellitus (GDM), perinatal mortality and morbidity.
Results: Higher incidence of twin gestation was noted between the age group of 20-25 years and maximum were of spontaneous conception. None of them had family history of twins or past history of the same. We noted that maximum were preterm deliveries and majority of the patients underwent lower segment caesarean section (LSCS). Twin specific complications were noted according to their chorionicity. Most of the babies weighed between 1.5-2.5 kg. Perinatal mortality was 7.5% and no maternal mortality noted.
Conclusions: The knowledge of maternal and fetal risks associated with multiple gestation helps in prevention of adverse outcome and better surveillance.
References
Mathew R, Wills V, Abraham J. Maternal determinants and fetal outcome of twin pregnancy: a five-year survey. Int J Reprod Contracept Obstet Gynecol. 2017;6:2459-65.
Jahanfar S, Lim K. Adverse maternal outcomes and birth weight discordance in twin gestation: British Columbia, Canadian data. Int J Womens Health. 2017;9:871-8.
Santana DS, Silveira C, Costa ML. Perinatal outcomes in twin pregnancies complicated by maternal morbidity: evidence from the WHO Multicounty Survey on Maternal and Newborn Health. BMC Pregnancy Childbirth. 2018;18:449.
Jones HW. Multiple births: How are we doing? Fertility sterility. 2003;79(1):17-21.
Bangal VB, Patel SM, Khairnar DN. Study of Maternal and Fetal Outcome In Twin Gestation At Tertiary Care Teaching Hospital. Int J Biomed Adv Res. 2012;3(10):758-62.
Blondel B, Kaminski M. Trends in the occurrence, determinants, and consequences of multiple births. Semin Perinatol. 2002;26(4):239-49.
Jewell SE, Yip R. Increasing trends in plural births in the United States. Obstet Gynecol. 1995;85(2):229-32.
Lee YJ, Kim MN, Kim YM, Sung JH, Choi SJ, Oh SY et al. Perinatal outcome of twin pregnancies according to maternal age. Obstet Gynecol Sci. 2019;62(2):93-102.
Jhaveri RR, Nadkarni TK. Perinatal Outcome of Second Twin with Respect to Mode of Delivery: An Observational Study. J Clin Diagn Res. 2016;10(12):QC26-8.
Gardosi J. Toward safe standards for assessment of fetal growth in twin pregnancy. Am J Obstet Gynecol. 2017;216(5):431-3.
Ma D, Szeto IM, Yu K, Ning Y, Li W, Wang J et al. Association between gestational weight gain according to prepregnancy body mass index and short postpartum weight retention in postpartum women. Clin Nutr. 2015;34(2):291-5.
Kumari, Misra K, Jhanwar M, Kumari A, Asha. Fetomaternal Outcome in Twin Pregnancies: A Retrospective Analysis from a Tertiary Care Centre. J clin diagnostic res. 2020;14:10.
Smits J, Monden C. Twinning across the Developing World. PLoS ONE. 2011;6(9):e25239.
Chowdhury S, Hussain MA. Maternal complications in twin pregnancies. Mymensingh Med J. 2011;20(1):83-7.
Bangal VB, Patel SM, Khairnar DN. Study of maternal and foetal outcome in twin gestation at tertiary care teaching hospital. IJBAR. 2012;3(10):758.
Rizwan N, Abbasi RM, Mughal R. Maternal morbidity and perinatal outcome with twin pregnancy. J Ayub Med Coll Abbottabad. 2010;22(2):105-7.
American College of Obstetricians and Gynecologists Committee on Practice Bulletins-Obstetrics; Society for Maternal-Fetal Medicine; ACOG Joint Editorial Committee. ACOG Practice Bulletin #56: Multiple gestation: complicated twin, triplet, and high-order multifetal pregnancy. Obstet Gynecol. 2004;104(4):869-83.
Chittacharoen A, Singhakun D, Ayudhya NI. Pregnancy outcome of twin pregnancy in Ramathibodi Hospital. J Med Assoc Thai. 2006;89(4):S76-80.
Qazi G. Obstetric and perinatal outcome of multiple pregnancy. J Coll Physicians Surg Pak. 2011;21(3):142-5.
