MATERNAL MORBIDITY AND PERINATAL OUTCOME WITH TWIN PREGNANCY
Abstract
Background: Multiple pregnancy still warrants special attention as it is associated with increasingrisk for mother and foetus. Preterm delivery increases the risk for baby. This study was conducted toevaluate the risks of pregnancy complications and adverse perinatal outcome in women with twinpregnancy. Methods: It was 2 years observational study from July 2007 to July 2009 at Departmentof Obstetrics and Gynaecology, Liaquat University Hospital, Jamshoro. All women admitted to thelabour ward with multiple pregnancy after 28 weeks gestation were included in the study. Mainoutcome measures were maternal complications (i.e., anaemia, preterm labour, pregnancy inducedhypertension, postpartum haemorrhage etc.), perinatal morbidity and mortality. All data collectedwas analysed using SPSS-16. Results: Incidence of multiple pregnancy in this study was 1.44%.Majority of women 52 (81%) were un-booked and only 12 (18%) were booked; 54 (84%) womenpresented with preterm labour, 10 (15.6%) were at ≥36 weeks of gestation. Fifty-four (84%) patientspresented with preterm labour. Anaemia was found in 42 (65.6%), and hypertension was noted in31.2% cases. Abruptio placentae occurred in 6.2% of cases, prematurity was the major problem (54,84.3%). Majority presented between 28–35 weeks gestation, 10 (15.6%) delivered at 36 weeks orabove. The most common cause of neonatal death was very low birth weight (in 32.8% cases),followed by sepsis and jaundice. Conclusion: Multiple pregnancy is associated with increasing riskfor mother and foetus. Preterm delivery increases the risk for baby.Keywords: Multiple pregnancy, pregnancy complications, preterm birthReferences
Fisk, NM. Multiple Pregnancy. In: Dewhurst’s Textbook of
Obstetrics & Gynaecology, Seventh Edition, Edmonds DK. ed,
Oxford UK: Blackwell Publishing; 2007.p. 166–7.
Chamberlain GPV. Multiple preganacnies. In: Baker PN.
Obstetrics by ten teachers. 15th edition, UK: Arnold; 1990.p. 136–
National Centre for Health Statistics–Multiple Births.
Naheed I. Zaineb A, Almas S. Twin pregnancy (high risk for the
mother & the feutus). Pak Postgrad Med J 2001;12:50–4.
La Sala GB, Gallinelli A, Nicoli A, Villani MT, Nucera G.
Pregnancy loss and assisted reproduction: preliminary results
after the law 40/2004 in Italy. Reprod Biomed Online
;13(1):65–70.
Child TJ, Henderson AM, Jan Tan SL. The desire for multiple
pregnancy in male and female infertility patients. Hum Reprod
;19:558–61.
Bangahs N. Outcome of twin pregnancy in unbooked cases. Pak
Armed Forces Med J 2005;55:323–6.
Alexander G, KOgan M, Martin J, Papiernik E. What are the
fetal growth patterns of singletons, twins, and triplets in the
United States? Clin Obstet Gynaecol 1998;41(1):114–25.
HFEA. Multiple pregnancies & birth; considering the risks.
London: Human Fertilisation and Embyrology Authority
Available from: http://www.hfea.gov.uk/does/
multiple_birth_final_Nov06.pdf [Accessed March 2008].
Cnattingius S, Haglund B, Kramer MS. Differences in late fetal
death rates in association with determinants of small for
gestational age fetuses: population based cohort study. BMJ
;316(7143):1483–7.
NICE. Intrauterine laser ablation of placental vessels for the
treatment of twin-to-twin transfusion syndrome–information
for the public. National Institute for Health and Clinical
Excellence (NICE) 2006. Available from:
http://www.nice.org.uk/ipg198publicinfo [Accessed March
.
Pharoah PO, Cooke T. Cerebral palsy and multiple births. Arch
Dis Child Fetal Neonatal Ed 1996;75(3):F174–7.
Hammond KR. Multi fetal pregnancy reduction. J Obstet
Gynaecol Neonatal Nurs 1989;27:338–43.
De Sutter P, Van der Elst J, Cetsier T, Dhont M. Single embryo
transfer and multiple pregnancy rate reduction in IVF/ICIS: a 5
year appraisal. Reproductive Bio Medicine Online
;6(4):464–9.
Armour K, Callister L. Prevention of triples and high order
multiple: Trends in reproductive medicine. J Perinat Neonatal
Nurs 2005;19(2):103–11.
Antsaklis A, Drakakis P, Vlazakis G, Michalas S. Reduction of
multifetal pregnancies to twins does not increase obstetrics or
perinatal risks. Human Reprod 1998;14(5):1338–40.
Ananth CV, Smulian JC, Demissie K, Vintzileos AM, Kunppel
RA. Placental abruption among singleton and twin births in the
United States: risk factors profiles. Am J Epidemiol
;153:771–8.
Day MC, Barton JR, O’Brien JM, Istwan NB, Sibai BM. The
effect of fetal number on the development of hypertensive
conditions of pregnancy. Obstet Gynecol 2005;106:927–31.
Syeda Batool Mazhar, Fariha Rahim and Tehmina Furukh.
Fetomaternal Outcome in Triplet Pregnancy. J Coll
Physicians Surg Pak 2008;18:217–21.
Akhtar S, Asif S. Twin Gestation–Antenatal Complications and
Fetal Outcome. Pak J Obstet Gynaecol 1996;9(1):23–6.
Malik MS, Rashid U. Complications of Twin Gestation.
Biomedica 1998;14:22–6.
Shinwell ES. Neonatal morbidity of very low birth weight infants
from multiple pregnancies. Obstet Gynecol Clin North Am
;32:29–38.
Naqvi MM. Outcome of Twin Pregnancy in booked versus
unbooked cases. J Coll Physicians Surg Pak 2003;13:498–500.
Kahn B, Lumey LH, Zybert PA, Lorenz JM, Cleary-Goldman
J, D’Alton ME, et al. Prospective risk of fetal death in singleton,
twin and triplet gestations: implications for practice. Obstet
Gynecol 2003;102:685–92.
Luke B, Keith LG. The contribution of singletons, twins and
triples to low birth weight, infant mortality and handicap in the
United States. J Reprod Med 1992;37:661–6.
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