Global Journal of Medical Research, E: Gynecology and Obstetrics, Volume 21 Issue 3

A Retrospective Study: Twin Pregnancy at Tertiary Care Centre, Maternal and Perinatal Outcome Dr. Nitesh Meena α , Dr. Rajendra Prasad Rawat σ & Dr. Heena Kaurani ρ Twin pregnancy imposes greater demand on maternal physiological system. There is an increase in occurrence of many complications like hypertensive disorders, anaemia, gestational diabetes mellitus (GDM), preterm labour, preterm premature rupture of membranes (PPROM), and placental abruption. It is also responsible for repeated antenatal admissions, longer hospital stay, and blood transfusions. It is associated with increase in operative vaginal or caesarean delivery, post-partum haemorrhage and hysterectomy. It eventually contributes to the three major causes of maternal mortality: post-partum haemorrhage, venous thromboembolism and hypertensive disorders. 4 II. M ethods This is a retrospective study, which was conducted at J.K.Lone hospital, Govt. Medical College Kota. 60women with twin pregnancies admitted to the labour room between January 2020 and December 2020 were included in the study. Ethical approval was taken from ethical committee before commencement of the study. Variable patient parameters like age, parity, and duration of gestation, physical examination, mode of delivery, antepartum, intrapartum and postpartum complications were collected. Data was retrieved from patient's case-notes and supplemented by information from the labour ward, postnatal ward, operation theatre and medical record department. Inclusion criteria included all twin gestations admitted to the labour room between 28 to 38 weeks gestation and both twins alive at time of randomization. Exclusion criteria were lethal fetal anomaly of either of the fetus. Women with pregnancies less than 28 weeks of gestation were excluded from the study. III. R esults Out of the total 4285 antenatal patients delivered during the period of 1 year from January 2020 to December 2020 in our hospital, 61 patients presented with multiple pregnancy. Of these, one had triplet pregnancy and was excluded from our study and rest 60 were cases of twin pregnancy. The incidence of twin pregnancy in our study was 1.4%. The distribution of cases in relation to maternal sociodemographic profile is shown in table 1. Maximum numbers of women (70%) 35 Year 2021 Global Journal of Medical Research Volume XXI Issue III Version I ( D ) E © 2021 Global Journals Abstract- Background: The objective of present study was to study the maternal and perinatal outcome in twin pregnancy in a tertiary care canter. Methods: Retrospective analytical review of all twin deliveries at J.K Lon hospital, Govt. medical college Kota, over a period of 1 year between January 2020 and December 2020.There were 60 twin deliveries. Maternal details, antenatal complications and fetal outcome were analysed. Results: The incidence of twin pregnancy was 1.4 % with maximum incidence in age group of 20 -29 years and in multigravida. Vertex - vertex fetal presentation was most common presentation. Most frequent mode of delivery was caesarean section (76.6%). Preterm labour was most common maternal complication (75%), followed by anaemia (60%). Complications in perinatal period were birth hypoxia (35%), intrauterine growth restriction (13.3%), hyper- bilirubinaemia (10%) and neonatal sepsis (3.3 %). 85% of the new-borns were LBW. Perinatal mortality in our study was 15%. Conclusions: Twin pregnancies were seen to be more in the younger age group. Preterm labour, anaemia, hypertension and malpresentation were the main complications while caesarean section was the most common mode of delivery. Diachronicity led to less fetal complications and low perinatal mortality. Early active intervention in twin gestation can reduce the maternal and fetal mortality and morbidity. Keywords: twin pregnancy, maternal outcome, perinatal outcome, preterm labour. I. I ntroduction ultiple gestation is considered a high-risk pregnancy. Currently, multiple gestations constitute up to 3% of all pregnancies. 1 There has been an increase in incidence of twins due to multiple reasons such as a rise in the number of women conceiving at an advanced age and in increase in use of assisted reproductive techniques. 2 Twin pregnancy is associated with increased maternal and perinatal morbidity and mortality as well as healthcare costs. 3 M Author α : Senior resident, Department of Obstetrics and Gynecology, J.K. Lone hospital, Kota, Rajasthan, India. e-mail: niteshmeena85@gmail.com Author σ : Professor, Department of Obstetrics and Gynecology, J.K. Lone hospital, Kota, Rajasthan India. e-mail: drrajendrarawat@gmail.com Corresponding Author ρ : Senior Resident, Department of Obstetrics and Gynecology, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India. e-mail: heenakaurani22@gmail.com