Maternal and Perinatal Outcome in Twin Gestation in a Referral Hospital at Visakhapatnam

Background: Multiple births have been a subject of great interest to various Scientists such as endocrinologists and geneticists, a source of fascination to some people and a causes concern to obstetrician and pediatricians. Multiple pregnancies are associated with many problems for the obstetrician during ante-natal, intranatal and postnatal periods. For the mother the prognosis is worse than a singleton pregnancy and for the fetus the prognosis is very depressing and it is associated with very high fetal mortality. Aim: To study various factors leading to maternal and fetal morbidity and mortality in multiple fetal gestations. Material and methods: Prospective observational study was carried out on 100 antenatal women with twin gestations who attended Victoria Government Hospital, a referral hospital for women and child at Visakhapatnam from October 2015 to September 2017. Maternal and perinatal morbidity and mortality and their causes were analyzed. Results: In this study, 73 women (73%) were booked and 27 women (27%) were unbooked. Maternal and perinatal complications were more in unbooked cases. Incidence of preeclampsia was 22%, gestational hypertension cases 10% and eclampsia cases twice more than the singleton pregnancy. Incidence of poly-hydromnios 5%, Anemia was 40%, APH was 1%, pre-term labour – 30%. Intrapatrum and postpartum complications like PROM – 20%, uterine inertia – 6%, cord prolapse – 2%, PPS – 13%, LSCS rate – 40%. Conclusion: Twin gestation is a high risk pregnancy associated with antenatal, intranatal and postnatal complications which cases increased morbidity and mortality of both mother and fetus. Early diagnosis, good antenatal care and treatment of antenatal complications, labor management in the tertiary center, liberal use of C-section also NICU will improve perinatal, maternal outcome.