Maternal and perinatal outcome in multifetal gestation

Authors

  • Tejal L. Patel Department of Obstetrics and Gynaecology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
  • Bhargavi Ajit Diwan Department of Obstetrics and Gynaecology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India http://orcid.org/0000-0001-5762-8964

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20220899

Keywords:

High risk pregnancy, Assisted reproduction technology, Optimum obstetrics care, Intensive neonatal care

Abstract

Background: Multifetal gestation is a high-risk pregnancy associated with increased maternal and fetal complications. The rate of multiple pregnancy has dramatically increased during the past decades, along with the diffusion of assisted reproduction technology (ART). The present study aims to investigate maternal and perinatal outcome in multifetal gestation.

Methods: The prospective study was carried in the department of obstetrics and gynaecology, B. J. medical college, civil hospital, Ahmedabad from August 2019 to July 2020. All cases of multifetal pregnancy either admitted from antenatal clinics or from labor room as emergency cases were included in the study.

Results: Out of total 7786 births during this period, 103 were twin pregnancies and 3 were triplets. The incidence was 1 in 73.5 births. Maternal complications observed were anaemia in 27.3% patients, preterm deliveries in 58% patients, PROM in 20.7% patients, hypertensive disorders of pregnancy in 13.2% patients, APH in 1.8% patients and PPH in 4.7% patients. No maternal mortality occurred. Fetal complications like gross congenital anomalies in 6.13% cases, single fetal demise in 8.49%, growth discordance in 7.53%, fetal growth restriction in 5.18% cases and 82% babies were low birth weight. Still birth rate was 8.01% and perinatal mortality rate was 12.3%.

Conclusions: Early detection of high-risk cases, timely referral, frequent antenatal visits and early hospitalization with optimum obstetrics care and intensive neonatal care set up are necessary to improve maternal and perinatal outcomes.

Author Biography

Bhargavi Ajit Diwan, Department of Obstetrics and Gynaecology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India

MS OBSTETRICS AND GYNAECOLOGY CIVIL HOSPITAL AHMEDABAD

References

Umeora OUJ, AneziOkoro EA, Egwuatu VE. Higher-order multiple births in Abakaliki, Southeast Nigeria. Singapore. Med J. 2011;52(3):163-7.

Conde-Agudelo A, Belizan JM, Lindmark G. Maternal morbidity and mortality associated with multiple gestation. Obstet Gynecol. 2000;95:899-904.

Yasmeen N, Aleem M, Iqbal N. Maternal and fetal complications in multiple pregnancies. Ann K Ed Med Coll. 2006;12:512-4.

Rao A, Sairam S, Shehata H. Obstetric complications of twin pregnancies. Best Pract Res Clin Obstet Gynaecol. 2004;18(4):557-76.

Rizwan N, Abbasi RM, Mughal R. Maternal morbidity and perinatal outcome with twin pregnancy. J Ayub Med Coll Abbottabad. 2010;22(2):105-7.

Blondel B, Kaminski M. Trends in the occurrence, determinants, and consequences of multiple births. Semin Perinatol. 2002;26:239-49.

Jewell SE, Yip R. Increasing trends in plural births in the United States. Obstet Gynecol. 1995;85:229-32.

Ananth CV, Chauhan SP. Epidemiology of twinning in developed countries. Semin Perinatol. 2012;36(3):156-61.

National Institute for Health and Clinical Excellence. Multiple prenancy. The management of twin and triplet pregnancies in the antenatal period. NICE clinical Guideline. 2011. Available at: http://guidance.nice.org.uk/cg129. Accessed on 20 February, 2020.

Gajera AV, Basavannayya HP, Kavitha C, Hiremath R. Feto-maternal outcome in twin pregnancy. Int J Reprod Contracept Obstet Gynecol. 2015;4:1836-9.

Little J, Thompson B. Descriptive epidemiology. In: McGillivray I, Campbell DM, Thompson BJ, editors. Twinning and Twins. New York: Wiley. 1988;37-66.

Yeasmin MS, Uddin J, Khanam SK. Maternal and Perinatal Outcome of Multiple Pregnancy in a Tertiary Care Hospital of Bangladesh. Chattogram Maa-O-Shishu Hospital Med College J. 2019;18(2):2019.

Mahendra RP, Bikash JK, Deepak D. Maternal and perinatal outcome in multiple pregnancy. A study at teaching Hospital, department of obstetrics and gynaecology, MTH, Pokara, Nepal. Am J Public Health Res. 2015;5a(3):135-8.

Ri-Na S, Zhu WW, Wei YM, Wang C. Maternal and neonatal outcomes in multiple pregnancy: A multicentre study in the Beijing population. Chronic Dis Translational Med. 2015;1:197-202.

Hada A, Baghela AS, Sethi D. Study of maternal and foetal outcome in multiple pregnancy. J Evolution Med. Dent Sci. 2016;5(59):4069-73.

Chowdhury S. Clinical study on twin pregnancy. FCPS, Bangladesh College physicians and Surgeons, Dhaka. 1998.

Sultana H. Feotal and maternal outcome of twin pregnancy-A study of 50 cases, Bangladesh college of physicians and Surgeons, Dhaka. 2002.

Irene YV, Vaneet K. An analytical study of pregnancy outcome in multifoetal gestation. J Obstet Gynecol India. 2007;57(6):509-12.

Bangal VB, Patel SM, Khairnar DN. Study of maternal and fetal outcome in twin gestation at tertiary care teaching hospital. IJBAR. 2012;03(10):758-61.

Spellacy WN, Handler A, Ferre CD. A case control study of 1253 twin pregnancies from 1982-1987. Perinatal database. 1990;75:198-71.

Hanumaiah I, Shivanand DR, Visweshwaraiah KG. Perinatal outcome ot twin pregnancies at a tertiary center, south India. Int J Biol Med Res 2013;4(1):2683-5.

Kullima AA, Audu BM, Geidam AD. Outcome of twin deliveries at the university of Maiduguri teaching hospital: a 5-year review. Niger J Clin Pract. 2011;14(3):345-8.

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Published

2022-03-25

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Original Research Articles