Comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy at tertiary care centre

Authors

  • Divya Gupta Department of Obstetrics and Gynecology, S.M.S. Medical College, Jaipur, Rajasthan, India
  • Premlata Mital Department of Obstetrics and Gynecology, S.M.S. Medical College, Jaipur, Rajasthan, India
  • Bhanwar Singh Meena Department of Obstetrics and Gynecology, S.M.S. Medical College, Jaipur, Rajasthan, India
  • Devendra Benwal Department of Obstetrics and Gynecology, S.M.S. Medical College, Jaipur, Rajasthan, India
  • . Saumya Department of Obstetrics and Gynecology, S.M.S. Medical College, Jaipur, Rajasthan, India
  • Sunita Singhal Department of Obstetrics and Gynecology, S.M.S. Medical College, Jaipur, Rajasthan, India
  • Richa Ainani Department of Obstetrics and Gynecology, S.M.S. Medical College, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20172319

Keywords:

Fetomaternal outcome, High-risk pregnancy, Singleton pregnancy, Twin pregnancy

Abstract

Background: Multiple pregnancy remains one of the highest risk situations for the mother, foetus and neonate despite recent advances in obstetrics, perinatal and neonatal care. Twin pregnancies have increased rates of obstetric and perinatal complications compared to singletons Objective of present study was comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy in Obstetrics and Gynaecology Department of S.M.S. Medical College, Jaipur.

Methods: This was a hospital based, prospective observational study done in the Department of Obstetrics and Gynaecology. S.M.S. Medical College, Jaipur from April 2015 to March 2016. 150 women with twin pregnancy and 150 women with singleton pregnancies at gestation age of 28 weeks and above coming for delivery and consented for the study were included in the study. Women with chronic medical disorder or chronic hypertension were excluded from the study. Maternal and neonatal outcome recorded and analysed.

Results: Occurrence of twin in our study was 2.82%. Risk of preterm labour was about nine times higher in twin pregnancies than the singleton (OR: 2.74, 95% CI; 1.4494-5.1884, P value 0.001). The risk of premature rupture of membrane was increased by 2.74 times in twin pregnancies (OR:2.74; 95% CI: 1.4494-5.1884, p value .001). There was 3-time increased risk of malpresentation (OR 3.14; CI:1.7184-5.7480, p value .00002) and 2.28 times increase in hypertensive disorder (OR 2.28; 95% CI: 1.0727-4.8823, p value .03) in twin pregnancies. The risk of asphyxia and septicaemia was 2.5 times more in twins.

Conclusions: Twin pregnancy is a high-risk pregnancy with more complications in mother and foetus and is a great challenge for obstetrician. So, it should be managed carefully at tertiary care centre to reduce the maternal and perinatal mortality and morbidity.

References

Pope RJ, Weintraub AY, Sheiner E. Vaginal delivery of vertex-nonvertex twins: a fading skill? Arch Gynecol Obstet. 2010;282:117-20.

Multiple Pregnancies: The management of twin and triplet pregnancies in the antenatal period. NICE Clinical Guidelines, No. 129. National Collaborating Centre for Women's and Children's Health (UK). London: RCOG Press; 2011.

Adamson H. Low birth weight in relation to maternal age and multiple pregnancies at Muhimbili National Hospital. DMSJ. 2006;14(2):55.

Musili FKJ. Multifoetal pregnancies at a maternity hospital in Nairobi. East Afr Med J. 2009;86(4):162-5.

Peter B. Prevalence of twin deliveries and perinatal outcomes in public hospitals in Dar es Salaam. M Med (Obstetrics and Gynaecology) Dissertation submitted to Muhimbili University of Health and Allied Sciences; 2012.

Olusanya BO. Perinatal outcomes of multiple births in southwest Nigeria. J Health Popul Nutr. 2011;29(6):639-47.

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

Abasiattai AM, Umoiyoho AJ, Utuk NM, Shittu DG. Incidence and mode of delivery of twin pregnancies in Uyo, Nigeria. Niger Med J 2010; 51(4): 170-172.

Iyiola OA, Oyeyemi FB, Raheem UA, FO M. Frequency of twinning in Kwara State, North-Central Nigeria. The Egyptian J Med Hum Genet. 2013;14:29-35.

Obiechina NJ, Okolie VE, Eleje GU, Okechukwu ZC, Anemeje OA. Twin versus singleton pregnancies: The Incidence, pregnancy complications and obstetric outcome in a Nigerian tertiary hospital. Int J Women Health. 2011;3:227-30.

Muthihir JT, Pam VC. Obstetric outcome of twin pregnancies in Jos, Nigeria. Nigerian J Clini Pract. 2007;10(1):15-18.

Chiwanga ES, Massenga G, Mlay P, Obure J, Mahande MJ. Maternal outcome in multiple versus singleton pregnancies in Northern Tanzania: A registry-based case control study. Asian Pacific J Reprod. 2014;3(1):46-52.

Garg P, Abdel-Latif ME, Bolisetty S, Bajuk B, Vincent T, Lui K. Perinatal characterstics and outcome of preterm singleton, twin and triplet infants in NSW and the Act, Australia (1994-2005). Arch Dis Child-Fetal Neonatal Ed. 2010;95(1):F20-F24.

Shebl O ET, Sir A, Sommergruber M, Tews G. The role of mode of conception in the outcome of twin pregnancies. Minerva Ginecol. 2009;61(2):141-52.

Mazhar SBPA, Mahmud G. Maternal and perinatal complication in multiple versus singleton pregnancies: a prospective two years study. J Pak Med Assoc. 2002;52(4):143-7.

Qazi G. Obstetric and perinatal outcome of multiple pregnancy. J Coll Physicians Surg Pak. 2011;21(3):142-5.

Sultana M, Khatun S, Ara R, Saha AK, Akhter P, Shah ABS. Maternal and perinatal outcome of twin pregnancy in a tertiary hospital. Ibrahim Card Med J. 2011;1(2):35-9.

Akaba GO, Agida TE, Onafowokan O, Offiong RA, Adewole ND. Review of twin pregnancies in a tertiary hospital in Abuja, Nigeria. J Health Popul Nutr. 2013;31(2):272-7.

Hanumaiah I, Shivanand DR, Visweshwaraiah KG, Hoolageri MS. Perinatal outcome of twin pregnancies at a tertiary care centre, South India. Int J Biol Med Res. 2013;4(1):2683-5.

Akinboro A, Azeez MA, Bakare AA. Frequency of twinning in southwest Nigeria. Indian J Hum Genet. 2008;14(2):41-7.

Foo JY, Mangos GJ, Brown MA. Characteristics of hypertensive disorders in twin versus singleton pregnancies. Pregnancy Hypertens. 2013;3(1):3-9.

Olusanya BO, Solanke OA: Perinatal correlates of delayed childbearing in a developing country. Arch Gynecol Obstet. 2012;285(4):951.

Sarojini R, Bhanu BT, Kavyashree KS. Evaluation of perinatal outcome in twin pregnancy at tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2014;3(4):1015-21.

Downloads

Published

2017-05-25

Issue

Section

Original Research Articles