Study of fetomaternal outcome in twin pregnancy

Authors

  • Bijal D. Rami Department of Obstetrics and Gynecology, Government Medical College and S.S.G Hospital, Vadodara, Gujarat, India
  • Somika Kaul Department of Obstetrics and Gynecology, Government Medical College and S.S.G Hospital, Vadodara, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20195316

Keywords:

Low birth weight, Lower segment cesarean section, Maternal outcome, Perinatal outcome, Singleton pregnancy, Twin pregnancy

Abstract

Background: Twin pregnancy being one of the causes of high-risk pregnancy is associated with both maternal and fetal complications. This study aims at analysing the fetal and maternal outcome in such cases. All cases were studied according to their parity, maternal age, fetal presentation, mode of delivery and gestational age.

Methods: This prospective study was conducted at one of the tertiary care teaching institutes over a period of one year from January 2018 to December 2018. Out of a total number of 7295 deliveries, 130 were twin pregnancy. It included all women admitted in labour room with clinical or ultrasound diagnosis of twin pregnancy after 20 weeks of gestation.

Results: In the present study incidence of twin pregnancy was 1.78%. We observed the highest incidence of twins in the age group of 20-29 years. The least incidence was below the age of 20 years. Incidence of twin pregnancy in our study in primipara was 47.7% and in multipara was 52.3%. Most of the patients (43%) delivered at 32-36 weeks of gestation. Maternal complications were noticed as anemia in 29.2% patients, pregnancy induced hypertension in 55.4% patients, post-partum hemorrhage in 4.6% patients, polyhydramnios in 3.1% patients, premature rupture of membranes in 8.5% patients, gestational diabetes in 0.8% patients and urinary tract infection in 2.3% patients. Majority of the patients delivered vaginally (60.8%), others by lower segment cesarean section (LSCS). In this study 95.8% babies were low birth weight. There were 34 neonatal deaths (13%).

Conclusions: Twin pregnancy is a high-risk pregnancy associated with significantly increased maternal morbidity, neonatal morbidity and mortality. Such pregnancies require good antenatal care, early detection of maternal and fetal complications and timely referral to a centre well equipped for management of such cases.

 

References

Nkyekyer K. Multiple pregnancy. In: Kwawukwume EY, Emuveyan EE, editors. Comprehensive obstetrics in the Tropics. Accra, Ghana: Asante and Hittscher Printing Press Ltd; 2002.

Walker MC, Murphy KE, Pan S, Yang Q, Wen SW. Adverse maternal outcomes in multifetal pregnancies. Br J Obstet Gynecol. 2004;111:1294-6.

Conde-Agudelo A, Belizan JM, Lindmark G. Maternal morbidity and mortality associated with multiple gestation. Obstet Gynecol. 2000;95:899-904.

Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Munson ML. Births: final data for 2002. Natl Vital Stat Report. 2003;52:1-113.

Pernoll ML, Melissa M. Multiple pregnancy. In: Decherney DH, Pernoll ML, editors. Current obstetric and gynaecologic diagnosis and treatment, 9th ed. New York, NY: Mc Graw Hill and Large medical books; 2003.

Luke B. Improving multiple pregnancy outcomes with nutritional intervention. Clin Obstet Gynecol. 2004;47:146-62.

Blickstein I, Goldman RD, Kupfermic M. Delivery of breech first twin: a multicentre retrospective study. Obstet Gynecol. 2000;95:37-42.

Hogle KI, Hutton EK, Mcbrien KA, Barret JF, Hannah ME. Cesarean delivery for twin: a systematic review and meta –analysis. Am. J Obstet Gynecol. 2003;88:220-7.

Sunday-Adeoye I, Twomey ED, Egwuatu VE. Births at mater Misericordiae hospital, Afikpo, South Eastern Nigeria. Niger J Clin Pract. 2008;11:231-4.

Pandole A, Swamy MS, Sardeshpande N, Mishra A, Kore SJ, Ambiye VR. Perinatal mortality in twin pregnancy: a retrospective analysis. J. Obstet. Gynecol. Ind. 2003;53(2):138-9.

Singh L, Trivedi K. Study of maternal and fetal outcome in twin pregnancy. Int J Reprod Contracept Obstet Gynecol. 2017;6:2272-8.

Mobeen SV, Jayasri S. Incidence of vaginal delivery versus caesarean section in twin pregnancy in primigravida and its maternal and fetal outcome. IOSR J Dent Med Sci. 2019;18(4):65-71.

Bhavana S, Shivanna S, Gopal N. A study on fetomaternal outcome in twin gestation in a tertiary rural health centre. Int J Adv Res Med Sci. 2014;1(1):15-7.

Reddy A, Madhavi KSS, Niharica. A study on risk of twin pregnancy. Int Arch Int Med. 2016;3(10):139-45.

Franca MS, Tatiana E. N. K. Hamamoto, Antonio AF. (December 14th2018). Preterm Birth in Twins, Multiple Pregnancy - New Challenges, Julio Elito Jr. Intech Open , intechopen ; 2014:82447.

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.

Brown EJ, Dixon HG. Twin pregnancy. J Obstet Gynecol Br Common. 1963;70:251.

Bhalla S, Bhatti SG, Devgan S. Obstetric and perinatal outcome of twin pregnancy: a prospective study in a tertiary care hospital in north India. Int J Repro Contracept Obstet Gynecol. 2018;7(6):2455-61.

Downloads

Published

2019-11-26

Issue

Section

Original Research Articles