Obstetric outcome of twin pregnancies at tertiary care teaching hospital

Abstract

Background: Twin Pregnancy is considered as a high risk pregnancy. According to Hellin’s rule one in about 89 natural pregnancies ends in birth of twins, one in 892 birth is triplet and one in 893 birth is Quadruplets. Maternal obstetric complications includes preterm labour, anaemia, pregnancy induced hypertension, eclampsia, complication of labour and postpartum haemorrage. Foetal complications include prematurity, low birth weight, perinatal mortality. The perinatal mortality rate associated with twin pregnancy is 4 time greater than with singleton pregnancy.

Methods: It was one year observational study from 2011 to 2012. All women admitted to the labour ward with twin pregnancy after 28 weeks gestation were included in this study. Data obtained at the time of delivery included maternal age, parity, gestational age at the time of delivery & foetal weight.

Results: A total of 18666 deliveries conducted, there were 206 cases of twin deliveries constituting incidence of 1.1% (1:90). Majority of cases were 20-25 year age group (58%). Mean age of cases was 24.94 year. Majority of cases were primigravidas (45%). Majority of women were unbooked (62%). Only 28% were registered, 43% were presented with preterm labour, PIH noted in 18%, anemia in 15% and APH in 3%. Most common cause of neonatal morbidity was preterm birth (41.5%). Perinatal mortality was maximum 100% in babies with birth weight < 1000gm & 76.92% in 1000-1499gm weight. Most common cause of neonatal death was very low birth weight.

Conclusions: Twin pregnancies are associated with increasing with morbidity of mother and foetus. Most of babies head respiratory distress or had developed neonatal sepsis. These death can be prevented by averting preterm birth by combined measures like good rest, cervical encirclage, administration of steroid in preterm labour, by institutional delivery and provision of level 3 neonatal care.