Abstract

Background: Multiple births are much more common today than they were in the past. The incidence of twin gestation has increased mainly due to advanced maternal age and assisted reproductive technology Throughout the world, the prevalence of twin births varies from approximately 2-20 /1000 birth. This delayed childbearing has resulted in an increased maternal age at conception. Twin gestation is considered as high-risk pregnancy as it contributes significantly to adverse maternal and perinatal outcomes. This study was conducted to evaluate the risks of pregnancy complications and adverse perinatal outcome in women with twin pregnancy. Multiple pregnancies are associated with an increased risk of obstetric complications as well as perinatal morbidity and mortality especially in developing countries.
Materials and Methods: Present study is a retrospective study of 223 cases of twin pregnancies admitted at our institute from Sept 2020 to Oct 2021 including all emergency as well as registered cases. In all cases a detailed history was taken, all routine and specific investigations were done. We studied maternal factors like age, parity, complications, mode of delivery and perinatal morbidity and mortality. Main outcome measures were maternal complications (i.e., anaemia, preterm labour, pregnancy induced hypertension, postpartum haemorrhage etc.) perinatal morbidity and mortality.
Results: In this retrospective study we observed 223 cases of twin pregnancies. In this study most of the patients (45.7%) delivered at 37- 42 weeks of gestation. 5% of patients had abortion at an early gestation. Majority of the patients delivered vaginally (51.56%), followed by LSCS (Lower Segment Caesarean Section) (48.43%). In this study low birth weight babies were the most common (138 babies) to the extent of 73.29%. We had 0.05% (13) extremely low birth weight babies. There were 38 neonatal deaths. We observed the highest incidence of twins in the age group of 26-30 years. The least were below the age of 20 years.
Conclusions: Most of the complications in multiple gestations can be prevented. High risk units in the obstetric ward and well developed NICU set up would reduce the maternal, perinatal morbidity and mortality. Good antenatal care, with increased rest and nutritional supplementation, early detection of fetal and maternal complications together with thorough intranatal and postnatal vigilance, can lower both maternal and fetal dangers.