Obstetric and perinatal outcome of twin pregnancy: a prospective study in a tertiary care hospital in North India
Keywords:Maternal morbidity, Preterm birth, Perinatal morbidity, Twin pregnancy
Background: Multiple pregnancy constitutes an important portion of high risk pregnancies and is a matter of grave concern to obstetricians and paediatricians owing to maternal and perinatal morbidity and mortality associated to it. Objective of present study was to evaluate maternal and perinatal outcome of twin pregnancy.
Methods: This observational study included 50 women with twin pregnancy with gestational age of 26 weeks or more. Maternal and perinatal outcomes were studied.
Results: The incidence of twin pregnancy was 2.8 % with maximum incidence in age group of 20 -29 years and in multigravida. Mean gestational age was 34.2 weeks. Vertex - vertex fetal presentation was most common presentation. Most frequent mode of delivery was ceserean section (54%). Preterm labour was most common maternal complication (74%), followed by anaemia (62%). Complications in perinatal period were birth hypoxia (58 %), intrauterine growth restriction (15 %), hyper-bilirubinemia (11%) and neonatal sepsis (10 %). 88% of the newborns were LBW. Perinatal mortality in our study was 17%.
Conclusions: Twin pregnancies are associated with significant maternal and perinatal morbidity which is more so for second twin. Effective antenatal care planned delivery and good pediatric facilities help decrease the complications. Managment of twin pregnancy requires multidisciplinary approach and involvement of skilled obstetricians and paediatricians.
Smits J, Monden C. Twinning across the developing world. PLoS One. 2011 Sep 28;6(9):e25239.
Sumathipala A, Siribaddana S, De Silva N, Fernando D, Abeysingha N, Dayaratne R, De Silva D, Warnasuriya N, Hotopf M. Sri Lankan twin registry. Twin Research and Human Genetics. 2002 Oct;5(5):424-6.
Aisien AO, Olarewaju RS, Imade GE. Twins in Jos Nigeria: a seven-year retrospective study. Med Sci Monit. 2000;6:945-50.
Obiechina N, Okolie V, Eleje G. Twin versus singleton pregnancies: the incidence, pregnancy complications, and obstetric outcomes in a Nigerian tertiary hospital. Int J Womens Health. 2011;3:227.
Doris MC. Multiple pregnancy. Baillieres Clin Obstet Gynaecol. 1990;4:109-27.
Bortolus R, Parazzini F, Chatenoud L, Benzi G, Bianchi MM, Marini A, The epidemiology of multiple births. Hum Reprod Update. 1999;5(2):179- 87.
Goetghebuer T, Ota MO, Kebbeh B, John M, Jackson Sillah D, Vekemans J et al. Delay in motor development of twins in Africa: a prospective cohort study. Twin Res. 2003;6(4):279-84.
Hoekstra C, Zhao ZZ, Lambalk CB, Willemsen G, Martin NG, Boomsma DI et al. Dizygotic twinning. Hum Reprod Update. 2008;14(1):37-47.
Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Munson ML. Births: Final data for 2002. Natl Vital Stat Rep. 2003;52(10):1-102.
Sultana H. Fetal and maternal outcome of twin pregnancy-A study of 50 cases. Bangladesh college of Physicians and Surgeons, Dhaka. 1998.
Spellacy WN, Handler A, Ferre CD. A case control study of 1253 twin pregnancies from 1982-1987. Perinatal Data Base. 1990;75:198-71.
Erdemoglu M, Kale A, Akdeniz N, Yalinkaya A, Ozcan Y. Retrospective analysis of multiple pregnancies. Perinatal Journal. 2005;13(4).
Irene YV, Vaneet K. An analytical study of pregnancy outcome in multifetal gestation. J Obstet Gynecol India. 2007 Nov;57(6):509-12.
Panwala NM, Mondkar AM, Ranade VR, Purandare VN. Multiple pregnancy. A review of 116 cases. J Postgrad med. 1972 Jul;18(3):108-114.
Chowdhury S. Clinical Study on twin pregnancy, FCPS. Bangladesh College of Physicians and Surgeons, Dhaka, 1998.
Papiernik E, Keith L, Oleszczuk JJ, Cervantes A. What interventions are useful in reducing the rate of preterm delivery in twins? In: Clinical Obstet and Gynecol. 1998:13-22.
Brown EJ, Dixon HG. Twin pregnancy. J Obstet Gynaecol Br Common. 1963;70:251.
Bangal VB, Patel SM, Khairnar DN. Study of maternal and foetal outcome in twin gestation at tertiary care teaching hospital. IJBAR. 2012;3(10):758.