Evaluation of perinatal outcome in twin pregnancy at tertiary care centre

Authors

  • Sarojini . Department of Obstetrics & Gynecology, BMCRI, Bangalore, Karnataka, India
  • Radhika . Department of Obstetrics & Gynecology, BMCRI, Bangalore, Karnataka, India
  • Bhanu BT Department of Obstetrics & Gynecology, BMCRI, Bangalore, Karnataka, India
  • Kavyashree KS Department of Obstetrics & Gynecology, BMCRI, Bangalore, Karnataka, India

Keywords:

Twin pregnancy, Perinatal mortality, Perinatal morbidity, Prematurity, Respiratory distress, Septicemia

Abstract

Background: The objective of present study was to study the incidence of perinatal mortality and morbidity in twin pregnancy and to analyse the various factors influencing perinatal outcome in these cases.

Methods: A total of 117 pregnant women with twin pregnancy were analyzed between the period of September 2010 to February 2012. After applying the inclusion and exclusion criteria these women were analyzed with respect to fetal presentation at the onset of delivery, mode of delivery, APGAR score at 1minute, incidence of perinatal mortality and morbidity rates. Also attempt has been made to define the factors which influence the perinatal mortality and morbidity in twins.

Results: In this study it is observed that there is increased incidence of malpresentations 50 (42.7%), increased incidence of congenital malformations (2.6%), increased perinatal mortality (16.7%) and morbidity (21.8%). It is observed that prematurity, i.e. gestational age <37 weeks contributed to 69.9% of total perinatal loss. All perinatal losses except 2 occurred in infants <2 kg. Major factors causing perinatal morbidity were respiratory distress syndrome in (6.4%), transient tachypnoea of newborn (6.4%), septicemia (4.3%), jaundice (3.8%) and anemia (0.9%).  

Conclusions: It is observed that in this study perinatal mortality and morbidity rates are increased in the event of a twin pregnancy more so for second twin. Early diagnosis of twin pregnancy, regular antenatal visits, identification and anticipation of complications, planned delivery and good NICU care will help to decrease the perinatal morbidity and mortality.

References

Cunningham FG, Leveno KJ, Bloom SL, Haulh JC, Gilstrap LC, Wenstrom KD. Multifetal gestation. In: Cunningham FG, Leveno KJ, Bloom SL, Haulh JC, Gilstrap LC, Wenstrom KD, eds. Williams Textbook of Obstetrics. 22nd ed. New York: McGraw-Hill; 2005: 911-948.

Daftary SN, Desai SV. Multiple fetal gestations. In: Daftary SN, Desai SV, eds. Textbook of Selected Topics in Obstetrics and Gynaecology-2, for Postgraduates and Practitioners. 19th ed. New Delhi: BI Publications Pvt Ltd; 2004: 52-72.

Jacob Bhargava. Review of 291 cases of multiple pregnancy. J Obstet Gynecol. 1973;23:302-11.

Pandole A, Swamy MSC, Panda S, Mishra A, Kore S, Ambiye VR. Perinatal mortality in twin pregnancy. A retrospective analysis. J Obstet Gynecol. 2003 Apr;53(2):138-9.

Ferguson. Perinatal mortality in 1609 multiple gestations. Obstet Gynecol 1964;23:861.

Koacs BW, Krischbaum FH, Paul RH. Twin gestation: antenatal care and complications. Obstet Gynecol. 1989;74:313-7.

Ho SK, Wu PYK. Perinatal factors and neonatal morbidity in twin pregnancy. Am J Obstet Gynecol. 1975;122:979-87.

Bhatia G. Twin pregnancy of 500 cases. Obstet Gynecol. 1978;57:25.

Jacob Bhargava. Review of 291 cases of multiple pregnancy. J Obstet Gynecol. 1973;23:302-11.

Chevernak FA, Johnson RE, Youcha S. Intrapartum external version of the second twin. Obstet Gynecol. 1983;62:160.

Tempe A. Twin versus singleton pregnancies by a comparison of morbidity and mortality. J Obstet Gynecol India. 1993;43:518-23.

Kore S. Evaluation of perinatal mortality in 363 of twins. J Obstet Gynecol India. 1997;47:74-9.

Mitra Sikdar. Clinical study of twin pregnancy. J Obstet Gynecol. 1986;(3):363.

Saacks CB, Thorp JM, Hendricks CH. Cohort study of twinning in academic health centers - changes in management and outcome over 40 years. Am J Obstet Gynecol. 1995;172:432.

Stagiannis KD, Sepulveda W, Southwell D. Ultrasonic measurement of the dividing membrane in twin pregnancy during the 2nd and 3rd trimesters: a reproducibility study. Am Journal Obstet Gynecol. 1995;173:1546.

Spellacy WN, Handler A, Ferre CD. A case control study of 1253 twin pregnancies from a 1982-1987 perinatal data base. Obstet Gynecol. 1990;75:168

Narvekar NM, Thakur SS. Labour and its outcome in 53 cases of twin pregnancy. J Obstet Gynecol India. 1998;48:581-4.

Rani R. Perinatal mortality in twin pregnancy: a retrospective study. J Obstet Gynecol India. 1995;30:720-30.

Cameron AH, Edwards JH, Deron R, Thiery M, Boelaert R. The study value of twin survey in the study of malformation. Eur J Obstet Gynecol Reprod Biol. 1993;14:34.

Downloads

Published

2017-02-10

Issue

Section

Original Research Articles