Obstetric and perinatal outcome of multiple pregnancy: a retrospective study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20231423Keywords:
Multiple gestation, Twin pregnancy, Multiple pregnancy, Obstetric outcomes, Neonatal outcomes, HypothyroidAbstract
Background: Obstetricians and paediatricians are concerned about multiple pregnancy because of its high association with maternal and perinatal morbidity and mortality. This study aims to determine the obstetric and perinatal outcome of multiple pregnancy at a teaching hospital in Southern India.
Methods: This retrospective study was conducted in the department of obstetrics and gynecology, Basaweshwar teaching and general hospital, and Sangmeshwar teaching and general hospital, attached to Mahadevappa Rampure medical college, Kalaburagi from August 2020 to August 2022. The analysis included data on 36 women between 20 and 35 years of age, with ≥ 24 completed weeks gestation, having multiple pregnancy during the study period after applying the exclusion criteria. The data was retrieved from the hospital medical records that included demographic details, complications of pregnancy, and maternal and neonatal outcomes. The data was expressed as frequencies, percentages, mean and standard deviation. Statistical data was analyzed using SPSS 20.0 software. Qualitative data of the maternal problems during intrapartum and postpartum period was done using the test of proportion and chi-square test was applied for significance. Quantitative data was analyzed by t test considering a p value less than 0.05 as statistically significant.
Results: There were a total of 36 women with multiple pregnancy with the overall incidence of 12.5 per 1,000 births (1.25%) during the study period. Preterm labour complicated 27.7% of multiple pregnancies, 13.8% of the multiple pregnancies were complicated by severe preeclampsia, 11.1% were complicated by imminent preeclampsia, 8.3% had intrauterine death in 1 of the twins, and 2.7% had oligohydramnios. 33.3% had iron deficiency anaemia, 22.2% had gestational hypertension, and 13.8% had hypothyroidism. There was no maternal morbidity. Majority (55%) were delivered by LSCS, whereas 44.4% were delivered vaginally. Postpartum haemorrhage complicated 5.5% of twin deliveries. The total fetal loss was 2.4%. There was no maternal mortality in our study.
Conclusions: There is higher incidence of adverse maternal and perinatal outcomes among multiple pregnancies than singleton pregnancies. This mandates adequate counselling about risks and required monitoring to avoid adverse outcomes.
References
Leveno KJ, Dashe JS, Hoffman BL, Spong CY, Casey BM. Williams Obstetrics; McGraw-Hill Education. 2022.
Bortolus R, Parazzini, F, Chatenoud L, Benzi G, Bianchi MM, Marini A. The Epidemiology of Multiple Births. Hum. Reprod. Update. 1999;5(2):179-87.
Hannoun A, Usta IM, Awwad J, Moukalled D, Yahya F, Jurdi A et al. Effect of Parity on Maternal and Neonatal Outcomes in Twin Gestations. Acta Obstet. Gynecol. Scand. 2012;91(1):117-21.
Evans MI, Berkowitz RL, Wapner RJ, Carpenter RJ, Goldberg JD, Ayoub MA et al. Improvement in Outcomes of Multifetal Pregnancy Reduction with Increased Experience. Am J Obstet Gynecol. 2001;184(2):97-103.
Vogel JP, Torloni MR, Seuc A, Betrán AP, Widmer M, Souza JP et al. Maternal and Perinatal Outcomes of Twin Pregnancy in 23 Low- and Middle-Income Countries. PloS One. 2013;8(8):e70549.
Singh L, Trivedi K. Study of Maternal and Fetal Outcome in Twin Pregnancy. Int. J. Reprod. Contracept. Obstet. Gynecol. 2017;6(6):2272-8.
Panwala NM, Mondkar AM, Ranade VR, Purandare VN. Multiple Pregnancy. A Review of 116 Cases. J. Postgrad. Med. 1972;18(3):108-14.
Erdemoğlu M, Kale A, Akdeniz N, Yalınkaya A, Özcan Y, Yayla M. Retrospective Analysis of Multiple Pregnancies. Perinat J. 2021;13(5):213-7.
Bhalla S, Bhatti SG, Devgan S. Obstetric and Perinatal Outcome of Twin Pregnancy: A Prospective Study in a Tertiary Care Hospital in North India. Int J Reprod Contracept Obstet Gynecol. 2018;7(6):2455-61.
Lakshmikantha G, Sangeetha C. Obstetric and Neonatal Outcome in Multiple Pregnancy in Rural India: A Prospective Study. Int. J Reprod Contracept Obstet Gynecol. 2018;7(11):4384-7.
Radhakrishnan R, Radhakrishnan R. Perinatal Outcome of Twin Pregnancy and Influence of Chorionicity on It. Kerala Med J. 2019;12(1):8-12.
