Published: 2016-12-16

A retrospective study: twin gestation at tertiary care, maternal and fetal outcome

Mamatha B. Shetty, Chaitra Shivananjaiah, Asha Swarup


Background: The objective of our study was to study the maternal and neonatal outcome in twin gestation in a tertiary care center.

Methods: A retrospective analysis of 197 twin pregnancies admitted and managed at M S Ramaiah medical college. Parameters in the mother and fetus were studied for any adverse antenatal complications, mode of delivery.

Results: Prim gravid patients with twin pregnancy constituted (45.6%). 4.5% of patients had an IVF conception. 45.1% patients were unbooked to our institute, 82% of the unbooked patients presented with preterm labour and preterm premature rupture of membrane. PIH was noted in 32.9% of the patients, premature rupture of membranes (32.9%), Intra- Uterine Death of one fetus (6.09%) and intra uterine growth retardation (2.03%) was the antenatal complications observed. Out of the 197 patients 63 (31.97%) delivered by vaginal route whereas 134 (68.02%) had to undergo cesarean section. Section for the second twin was done in 4(2.03%). The 197 women of twin pregnancy gave birth to 378 live-born babies, 16(9.5%) stillborn and 32 (16.2%) died by the end of seven days due to complications related to prematurity: hyaline membrane disease, hyperbilirubinemia.

Conclusions: Early active intervention in twin gestation can reduce the maternal and fetal mortality and morbidity.


Twin pregnancy, Presentation, Maternal outcome, Perinatal outcome, Preterm labour, Low birth weight

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WHO, UNiCEF, UNFPA, World Bank (2012) Trends in Maternal Mortality: 1990 to 2010. World Health Organization.

UNiCEF, WHO, World Bank, United Nations (2012) Levels and Trends in Child Mortality Report 2012. UNICEF.

American College of Obstetricians and Gynecologists: Special problems of multiple gestation. Education bulletin No. 253, 1998.

Bortolus R, Parazzini F, Chatenoud L, Benzi G, Bianchi MM, Marini A. The epidemiology of multiple births. Hum Reprod Update. 1999;5:179-87.

Hoekstra C, Zhao ZZ, Lambalk CB, Willemsen G, Martin NG, Boomsma DI et al. Dizygotic twinning. Hum Reprod Update. 2008;14:37-47.

Nylander PP. The factors that influence twinning rates. Acta Genet Med Gemellol (Roma). 1981;30:189-202.

Blondel B, Kaminski M. Trends in the occurrence, determinants, and consequences of multiple births. Semin Perinatol. 2002;26:239-49.

European Society of Human Reproduction and Embryology (ESHRE) Capri Workshop Group. Multiple gestation pregnancy. Hum Reprod. 2000;15:1856-64.

Norwitz ER, Edusa V, Park JS. Maternal physiology and complications of multiple pregnancy. Semin Perinatol 2005; 29:338- 48.

Conde-Agudelo A, Belizán JM, Lindmark G. Maternal morbidity and mortality associated with multiple gestations. Obstet Gynecol. 2000:95(6 Pt 1):899-904.

Cruikshank DP. Intrapartum management of twin gestations. Obstet Gynecol. 2007;109:1167-76.

Conde-Agudelo A, Belizan JM, Lindmark 0. Maternal morbidity and mortality associated with multiple gestations. Obstet Gynecol. 2000;95:899904.

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