Published: 2019-10-23

Twin pregnancy, the study of maternal and perinatal outcome: what being a twin is like?

Smitha K., Jasiya Afreen M. H.


Background: Twin pregnancy is considered as a high-risk pregnancy due to associated high maternal and perinatal morbidity mortality in comparison with singleton pregnancy. The objectives of this study were to study the maternal and perinatal complications in twin pregnancies. To find out various factors that contribute to adverse perinatal outcome.

Methods: This retrospective study was conducted at Kempegowda Institute of Medical Sciences Hospital, Bengaluru. 92 women with twin pregnancies admitted in KIMS Hospital from September 2014 to September 2018, both booked and referred patients were studied. Individual patient parameters like age, parity, gestational age, mode of delivery, maternal complications were tabulated. Neonatal morbidity and mortality were noted, data thus obtained was analysed and results studied.

Results: In the study the incidence of twin pregnancies was more in second gravida (53%). 72% of the patients were admitted between 28-36 weeks of gestation with preterm labour (23%) as the main cause for admission. Anaemia (8.69%), hypertensive disorders of pregnancies (17.39%), PPROM (21%), single foetal demise (5%) and IUGR (5.4%) were the antenatal complications observed. Out of the 92 patients, 29 (35.4%) patients delivered by vaginal route whereas 53 (64.6%) had to undergo C-section. DCDA twin constituted 66% of twins in the study and mal presentation was the commonest indication for caesarean section (50%). Among the 164 babies out of 92 twin pregnancies 8 babies were still born and 12 babies died by the end of one week due to complications related to prematurity like hyaline membrane disease, IVH.

Conclusions: Early detection of twin pregnancies and proper antenatal care reduces both maternal and perinatal complication thereby improving maternal and perinatal outcome.


Assisted reproductive technology, Intrauterine growth retardation, Maternal outcome, Neonatal mortality, Preterm labor, Twins

Full Text:



Martin JA, Hamilton BE, Ventura SJ. Births. Final data for 2010. Natl Vital Stat Rep. 2012;61(1):1.

Cunningham FG, Leveno KG, Bloom SL, Sponge CY, Dashe JS, Hoffman BL, et al. Multifetal pregnancy. In: Williams Obstetrics (24th ed). New York; 2014:891-924.

Aston K, Peterson C, Carrell D. Monozygotic twinning associated with assisted reproductive technologies: a review. Reprod. 2008;136(4):377.

Vanaja G, Devi PU, Devi DH, Prasad U, Kumari PD, Madhuri Y. Maternal and perinatal outcome in twin gestation in a referral hospital at Visakhapatnam. 2018.

Young BC, Wylie BJ. Effects of twin gestation on maternal morbidity. Semin Perinatol. 2012;36:162-8.

Tilahun T, Araya F, Tura G. Incidence and risk factors of twin pregnancy at Jimma University Specialized Hospital, Southwest Ethiopia. Epidemiol. 2015;5:188.

National Institute for Health and Clinical Excellence. Multiple pregnancy. The management of twin and triplet pregnancies in the antenatal period. NICE clinical Guideline. 2011. Available at:

Dutta DC. Textbook of obstetrics including perinatology and contraception. 6th ed. Calcutta: New Central Book Agency (P) Ltd; 2013.

Vendittelli F, Rivière O, Crenn‐Hébert CA, Riethmuller D, Schaal JP, Dreyfus M. Is a planned cesarean necessary in twin pregnancies ? Acta Obstetricia Gynecol Scandinavica. 2011;90(10):1147-56.

Adler-Levy Y, Lunenfeld E, Levy A. Obstetric outcome of twin pregnancies conceived by in vitro fertilization and ovulation induction compared with those conceived spontaneously. Eur J Obstet Gynecol Reprod Biol. 2007;133:173-8.

Rosner B, Fundamentals of Biostatistics, 5th Edition, Duxbury. 2000:80-240.

Riffenburg RH. Statistics in Medicine, second edition, Academic press. 2005:85-125.

Rao PSS, Richard J. An Introduction to Biostatistics, A manual for students in health sciences, New Delhi: Prentice hall of India. 4th edition; 2006:86-160.

Suresh KP, Chandrasekhar S. Sample size estimation and power analysis for clinical research studies. J Human Reprod Sci. 2014;5(1):7-13.

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.

Chowdhury S, Hussain MA. Maternal complications in twin pregnancies. MMJ. 2011;20(1):83-7.

Shetty MB, Shivananjaiah C, Swarup A. A retrospective study: twin gestation at tertiary care, maternal and fetal outcome. Int J Reprod Contracept Obstet Gynecol. 2016;5:217-9.

Radhakrishnan R, Radhakrishnan R. Perinatal outcome of twin pregnancy and influence of chorionicity on it. Int J Prev Ther Med. 2014;2(1):10-4.

Sheela SR, Patila A. A study of maternal and foetal outcome in multifoetal gestation at a rural based teaching hospital-a retrospective analysis. Int J Biol Med Res. 2014;5(2):3994-7.

Pandey MR, Kshetri BJ, Dhakal D. Maternal and perinatal outcome in multifetal pregnancy: a study at a teaching hospital. Am J Public Health Res. 2015;3(5A):135-8.