DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20163883

Study of neonatal outcome in multiple gestation

Garima Girish Arora, Gourav Rajendrasingh Bagga, Girish C. Arora

Abstract


Background:Development of more than one fetus inside the uterus is called multifetal gestation or multiple pregnancy. It’s a great challenge to the concerned obstetricians, due to late diagnosis and related complications. The main causes of perinatal mortality are prematurity, congenital defects, malpresentations, placental insufficiency and traumatic deliveries. Therefore understanding of twinning phenomenon is needed to improve perinatal outcome of this high risk pregnancy. The aims and objectives were to study fetal outcome in patients with multiple gestation.

Methods:A prospective observational study carried out during the period of 1 year. A total of 200 patients with antenatal clinical and ultrasound confirmed diagnosis of multiple gestation were enrolled for the study. After taking proper consent for the study, proper history, clinical and obstetrical examinations were conducted and findings noted. Mothers and neonates were followed till discharge from the hospital.

Results:Most common presentation was vertex of both foetuses (62.63%). 70.14% patients underwent spontaneous vaginal delivery and 20.32% underwent LSCS with malpresentation being the most common indication of LSCS. 40.70% patients delivered foetuses of opposite sex. 78.89% had dichorionic and diamniotic placenta. 78.89% had binovular twins. 33.66% foetuses had birth weight between 1.6 to 2 kgs (low birth weight). Prematurity was the most common fetal complication (34.91%). Total perinatal mortality rate is 14.21%. Prematurity was most common cause of neonatal mortality. 6.73% are still birth rate. IUGR was the most common cause of still births.

Conclusions: Multiple gestation is a mixed blessing and if successful, allows a couple to rapidly expand their family with a minimum number of pregnancies but it’s a great challenge to the concerned obstetricians. Complications due to multiple gestation are associated with adverse maternal outcome.

1.       Cunningham FG. William obstetrics. 23rd edn, McGraw Hill; 2010:859-888.

2.       Jewell SE, Yip R. Increasing trends in plural births in U.S. -obstet. Gynecol. 1995;85;229-32.

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

4.       Patel F, Hall DR. Twin pregnancies, risks and complications: a review article. Obstetrics and Gynecology Forum. 2004;14(3):13-9.

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

6.       Katke RD, Thakre NN. Multifetal Pregnancy: Maternal and Neonatal Outcome. Obstet Gynecol Int J. 2015;3(1):00068.

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

8.       Yuel VI, Kaur V. An analytical study of pregnancy outcome in multifetal gestation. J Obstet Gynecol India. 2007;57(6):509-12.

9.       Erdemoglu M, Kale A, Akdeniz N, Yalinkaya A, Ozcan Y. Retrospective Analysis of Multiple Pregnancies. Perinatal Journal. 2005;13(4).

10.    Gandye LM. Maternal and Perinatal outcome among multiple pregnancies delivering at Bugando Medical Centre and Sekou Toure Regional Hospital in Mwanza, Tanzania. 2013.

11.    Tempe A, Batra S, Nankana J. Twin versus singleton pregnancy: A comparison of morbidity and mortality. J. Obstet. Gynecol. Ind. 1993;43(4):518-23.

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

13.    Guttamcher AF. An analysis of 521 cases of twin pregnancy. Differences in single ovum and double ovum twinning, Am J Obstet Gynaecol. 34:76-84.

14.    Joseph K. Perinatal Mortality in twin pregnancy. Obstetrics and Gynecology: Wolters Kluwer. 1964;23(5):738-44.

Cite this article as: Arora GG, Bagga GR, Arora GC. Study of neonatal outcome in multiple gestation.Int J Reprod Contracept Obstet Gynecol 2016;5:4025-30.

Su RN, Zhu WW. Maternal and Neonatal outcomes in multiple pregnancy: A multicenter study in the Beijing population. Chronic Diseases and Translational Medicine. 2015;1:197-202. 

Keywords


Multifetal gestation, Multiple pregnancy, Neonatal outcome, Neonatal mortality, Perinatal mortality, Still birth

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References


Cunningham FG. William obstetrics. 23rd edn, McGraw Hill; 2010:859-888.

Jewell SE, Yip R. Increasing trends in plural births in U.S. -obstet. Gynecol. 1995;85;229-32.

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

Patel F, Hall DR. Twin pregnancies, risks and complications: a review article. Obstetrics and Gynecology Forum. 2004;14(3):13-9.

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

Katke RD, Thakre NN. Multifetal Pregnancy: Maternal and Neonatal Outcome. Obstet Gynecol Int J. 2015;3(1):00068.

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

Yuel VI, Kaur V. An analytical study of pregnancy outcome in multifetal gestation. J Obstet Gynecol India. 2007;57(6):509-12.

Erdemoglu M, Kale A, Akdeniz N, Yalinkaya A, Ozcan Y. Retrospective Analysis of Multiple Pregnancies. Perinatal Journal. 2005;13(4).

Gandye LM. Maternal and Perinatal outcome among multiple pregnancies delivering at Bugando Medical Centre and Sekou Toure Regional Hospital in Mwanza, Tanzania. 2013.

Tempe A, Batra S, Nankana J. Twin versus singleton pregnancy: A comparison of morbidity and mortality. J. Obstet. Gynecol. Ind. 1993;43(4):518-23.

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

Guttamcher AF. An analysis of 521 cases of twin pregnancy. Differences in single ovum and double ovum twinning, Am J Obstet Gynaecol. 34:76-84.

Joseph K. Perinatal Mortality in twin pregnancy. Obstetrics and Gynecology: Wolters Kluwer. 1964;23(5):738-44.

Su RN, Zhu WW. Maternal and Neonatal outcomes in multiple pregnancy: A multicenter study in the Beijing population. Chronic Diseases and Translational Medicine. 2015;1:197-202.