Analysis of maternal and fetal outcome in twin pregnancy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20250186Keywords:
Dichorionic twins, Monochorionic twins, Multiple pregnancies, Preterm labourAbstract
Background: The use of fertility drugs, in-vitro fertilization, gestational age and other factors contribute to the rising incidence of multiple pregnancies. Multiple pregnancies are associated with increased risk of obstetric complications and perinatal mortality and morbidities. The present study analyzes maternal and perinatal outcomes in multiple pregnancies to identify associated complications and reduce risks.
Methods: A retrospective study was conducted in the OBG department of MMCRI, from January 2023 to December 2023. Data from 182 twin deliveries were analyzed. All women diagnosed with twin pregnancies via clinical or ultrasound examination were included.
Results: Of the 7598 deliveries recorded, 182 (3.72%) were twin deliveries. The mean maternal age was 27.32±4.5 years. Most twin pregnancies occurred in multigravida women (67.7%) and were conceived after ovulation induction (74.43%). Dichorionic twins (71.4%) were more common than monochorionic twins (19.54%). Spontaneous delivery occurred in 132 (71.4%) cases, while 28.6% were induced. The rate of LSCS was 34.67%, with the most common indication being first twin not being cephalic. Preterm labour (72.7%), anemia (42%) and hypertensive disorders (38%) and postpartum hemorrhage (14.33%) were the most common complications. Single fetal demise occurred in 10% cases 10%.
Conclusions: Twin pregnancies are more common in advanced maternal age and often result from fertility treatments. Early diagnosis, vigilant prenatal and postnatal care and timely intervention can significantly reduce maternal and perinatal risks.
Metrics
References
Santana DS, Surita FG, Cecatti JG. Multiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity. Rev Bras Ginecol Obstet. 2018;40(9):554-62. DOI: https://doi.org/10.1055/s-0038-1668117
In Vitro Fertilization and Multiple Pregnancies. Ont Health Technol Assess Ser. 2006;6(18):1-63.
Dickey RP. The relative contribution of assisted reproductive technologies and ovulation induction to multiple births in the United States 5 years after the Society for Assisted Reproductive Technology/American Society for Reproductive Medicine recommendation to limit the number of embryos transferred. Fertil Steril. 2007;88(6):1554-61. DOI: https://doi.org/10.1016/j.fertnstert.2007.01.112
Marleen S, Kodithuwakku W, Nandasena R, Mohideen S, Allotey J, Fernández-García S, et al. Maternal and perinatal outcomes in twin pregnancies following assisted reproduction: a systematic review and meta-analysis involving 802 462 pregnancies. Human Reproduction Update. 2024;30(3):309-22. DOI: https://doi.org/10.1093/humupd/dmae002
Chalouhi GE, Stirnemann JJ, Salomon LJ, Essaoui M, Quibel T, Ville Y. Specific complications of monochorionic twin pregnancies: twin-twin transfusion syndrome and twin reversed arterial perfusion sequence. Semin Fetal Neonatal Med. 2010;15(6):349-56. DOI: https://doi.org/10.1016/j.siny.2010.09.003
Liu S, Li G, Wang C, Zhou P, Wei Z, Song B. Pregnancy and obstetric outcomes of dichorionic and trichorionic triamniotic triplet pregnancy with multifetal pregnancy reduction: a retrospective analysis study. BMC Pregn Childbirth. 2022;22:280. DOI: https://doi.org/10.1186/s12884-022-04617-y
Abdulsalam FAM, Bourdakos NE, Burns JWF, Zervides ZY, Yap NQE, Adra M, et al. Twin pregnancy and postpartum haemorrhage: a systematic review and meta-analysis. BMC Pregnan Childbirth. 2024;24(1):649. DOI: https://doi.org/10.1186/s12884-024-06798-0
Roman A, Ramirez A, Fox NS. Screening for preterm birth in twin pregnancies. Am J Obstet Gynecol MFM. 2022;4(2S):100531. DOI: https://doi.org/10.1016/j.ajogmf.2021.100531
Hacking D, Watkins A, Fraser S, Wolfe R, Nolan T. Respiratory distress syndrome and birth order in premature twins. Arch Dis Child Fetal Neonatal Ed. 2001;84(2):F117-21. DOI: https://doi.org/10.1136/fn.84.2.F117
Upreti P. Twin pregnancies: incidence and outcomes in a tertiary health centre of Uttarakhand, India. Int J Reproduct Contracept Obstetr Gynecol. 2018;7(9):3520-5. DOI: https://doi.org/10.18203/2320-1770.ijrcog20183375
Kuppan AJ, Samuel V, Mahesh R, Jaganath PM, Anil S. Twinning rates in Chennai, India – A cross-sectional study. J Fam Med Prim Care. 2022;11(4):1450-4. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1223_21
Gigi A, Alexander R, Radhamani K. Effects of twin pregnancy chorionic properties on fetal outcomes: a comparative study. Int J Reproduct Contracept Obstetr Gynecol. 2020;9(9):3802-9. DOI: https://doi.org/10.18203/2320-1770.ijrcog20203860
Feng B, Zhai J, Cai Y. Effect of twin pregnancy chorionic properties on maternal and fetal outcomes. Taiwan J Obstet Gynecol. 2018;57(3):351-4. DOI: https://doi.org/10.1016/j.tjog.2018.03.002
Sekhasaria P, Chundawat RS, Shivrayan S, Agarwal A, Jakhar B. Study of maternal and perinatal outcomes in twin pregnancies delivered at a tertiary centre hospital in Southern Rajasthan. Inter J Reproduct Contracep Obstetr Gynecol. 2024;13(12):3685-90. DOI: https://doi.org/10.18203/2320-1770.ijrcog20243605
Kundariya KR, Shah JM, Mewada BN, Shah MM, Patel AS. Fetomaternal outcome in twin pregnancy. J South Asian Federat Obstetr Gynaecol. 2023;14(6):663-6. DOI: https://doi.org/10.5005/jp-journals-10006-2149
Jain D, Purohit RC. Review of twin pregnancies with single fetal death: management, maternal and fetal outcome. J Obstet Gynaecol India. 2014;64(3):180-3. DOI: https://doi.org/10.1007/s13224-013-0500-5
Enbom JA. Twin pregnancy with intrauterine death of one twin. Am J Obstet Gynecol. 1985;152(4):424-9. DOI: https://doi.org/10.1016/S0002-9378(85)80152-6