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Perinatal outcome of twin pregnancies at a tertiary care centre, south india

Authors:Indira Hanumaiah , Doddarangaiah R Shivanand , Kumar G Visweshwaraiah , Mahesh.S.Hoolageri
Int J Biol Med Res. 2013; 4(1): 2683-2685  |  PDF File

Abstract

BACKGROUND: Twin gestation is a high risk pregnancy with unique complications which have important implications on the perinatal adverse effects. Compared to singletons, multiple births are associated with a substantially-higher risk of maternal and perinatal mortality worldwide. It is also high risk delivery, especially so for the second of the twin. However, little evidence exists on the perinatal profile of twin pregnancy. OBJECTIVES: To study the perinatal outcome in twin pregnancies at a tertiary care centre. METHODS: It is a prospective study of 92 consecutive twin gestations achieving a gestational age of 28weeks and above at a tertiary care hospital, South India, for a period of two years. Perinatal outcomes including perinatal morbidity and mortality in relation to gestational age, mode of delivery and birth weight of the baby were analyzed. Various reasons for babies requiring NICU admission were noted. RESULTS: There were 4525 deliveries in the same institution during the study period. Incidence of twin gestation observed was 20.3 per 1000 births. Preterm labour was observed in 74% of patients. Perinatal mortality observed in this study was 15.2%. 57 (61.95%) spontaneous deliveries showed 19(67.85%) of perinatal mortality compared to 23(25%) LSCS which showed 5(17.85%) of perinatal mortality. In our study various reasons found for NICU admission were respiratory distress syndrome2(2.17%), very low birth weight35(19.02%) , and birth asphyxia in 2(2.17%) of cases and majority of them were second twin. Perinatal mortality observed in twins with gestational age 34-36weeks was 9(32.14%). 17(60.71%) of perinatal mortality was observed in VLBW babies. Data collected was analyzed with descriptive statistics like percentage and proportion. CONCLUSION: Prolongation of gestation by optimum care of mothers with twin gestation in the antenatal period has a beneficial effect on improvimg the perinatal outcome. Perinatal mortality can also be reduced by appropriate management protocols directed towards prolonging the gestational age, increasing the birth weight and optimizing the mode of delivery.