Study Of Maternal And Fetal Outcome In Twin Gestation At Tertiary Care Teaching Hospital

Abstract

Brief Introduction: Twin gestation is considered as high risk pregnancy due to associated high maternal morbidity and perinatal mortality in comparison with singleton pregnancies.Overall, the rate of twin gestation is on rise due to inadvertent use of ovulation induction drugs and assisted reproductive techniques.This study was carried out to find out the maternal and perinatal outcome in diagnosed cases of twin gestation Materials & Methods: 50 antenatal mothers with twin gestation delivered at Mamata general hospital, khammam, Andhra Pradesh, India from January 2012 to july 2013 which is a tertiary care referral centre were included in the study. Clinical Cases or Summary Results: It was observed that the incidence of twins was 1.49%.thirty eight percent cases were booked and attended antenatal clinic on regular basis.Preterm labour (42%) was the commonest obstetric complication, whereas, nutritional anemia (33%) and pregnancy induced hypertension (9%) were the commonest medical complications encountered.The rate of caesarean section was 16.5%.There was no serious maternal morbidity Twin gestation is considered as high risk pregnancy due to associated high maternal morbidity and perinatal mortality in comparison with singleton pregnancies .Overall, the rate of twin gestation is on rise due to inadvertent use of ovulation induction drugs in assisted reproductive techniques. This observational study was carried out to find the maternal and perinatal outcome in 100 cases of twin gestation delivered at tertiary care referral hospital over a period of fifteen months. It was observed that the incidence of twins was 1.49 % .Seventy six percent cases were booked and attended antenatal clinic on regular basis .Preterm labour (84%) was the commonest obstetric complication ,whereas ,nutritional anemia (66%) and pregnancy induced hypertension (18%) were the commonest medical complications .The rate of caesarean section was 33%.There was no serious maternal morbidity or mortality .There were 35 perinatal deaths ,of which 20 were early neonatal deaths. Extreme prematurity (37%) and very low birth weight (33%) predisposed majority of perinatal deaths. Causes of neonatal deaths were respiratory distress, fulminant septicemia ,pulmonary hemorrhage and DIC. Judicious use of ovulation induction drugs can reduce the incidence of twin gestation. Early diagnosis of twin gestation with its chorionicity, careful monitoring for fetal wellbeing throughout the pregnancy ,regular antenatal checkups, adequate rest, good diet, cervical encirclage in selective cases, maternal gluco-corticoids therapy in preterm labour, short term tocolysis and institutional delivery having level III neonatal back up facilities can improve the maternal and perinatal outcome in twin gestation.