A study of maternal and fetal outcome in multifetal gestation at a rural based teaching hospital - a retrospective analysis

Abstract

OBJECTIVES: To study the maternal and the fetal outcome in multifetal gestation at a tertiary care centre at Kolar. METHODS : This is a retrospective study from July 2012 to June 2013. All pregnant women with multifetal gestation admitted at R L Jalappa Hospital , during this period were included in the study. The medical records of cases were retrieved and analyzed for various demographic features, complications of pregnancy, maternal and neonatal outcome. RESULTS : The incidence of twin pregnancy in our set up is 2.6% and was highest in the age group of 21-25 yrs (51%). Family history was present in 26%, and history of ovulation induction in 6%. 48.3% had preterm labour, 27.4 % had anemia and 14.5% had severe preeclampsia complicating pregnancy. 59.6 % delivered vaginally, 40.3% had cesarean deliveries and the most common indication was malpresentation of the first twin. Preterm deliveries were seen in 61.2% and 33.8% had term deliveries. Post partum complications were seen in 9.6% of the patients, commonest being PPH-6.4% and there was 1 case of post partum eclampsia and one maternal mortality due to cardiac failure. 49% of the babies had birth weight between 1.5-2 kg. and 7.25% were >2.5 kg. 37 babies required NICU admission and there were 15 perinatal death(12.09%) prematurity being the most common cause for death. CONCLUSION : Twin pregnancy is a significant risk factor for maternal and perinatal morbidity and mortality in low-resource settings; Improved obstetric care and neonatal services and health education of the mother and health care providers will improve the outcome in twin pregnancy.