Maternal and perinatal outcome of twin pregnancy: A prospective study in tertiary hospital in Kashmir

Background: Multiple pregnancy is associated with increased maternal and fetal risk, therefore, warrants special attention. This study was conducted to evaluate the pregnancy complications and perinatal outcome in twin pregnancy. Methods: This observational study included 670 women with twin pregnancy achieving a gestational age of 28 weeks and above. Main outcome measures were maternal complications (i.e., anemia, PIH, preterm labour, PPH etc.), perinatal morbidity and mortality. Data was analyzed using SPSS-16. Results: The incidence of twin gestation observed was17.99 per 1000 births with maximum incidence of twining in the age group 26-35 years and in multigravida. Maternal and neonatal complications were remarkably higher with twin gestation. Maternal complications included anemia (41.94%), preterm labour (35.97%), hypertension (30%), PROM (23.88%), hyperemisis gravidarum (6.26%), gestational diabetes (10%), APH (6.26%) and PPH (11.94%). LSCS was done for both twins in 201 (30%) cases and for 2nd twins in 28 cases in view of placental prolapse and fetal distress. Most of the twins (75%) were delivered before 37 weeks and majority of newborn (>90%) had low birth weight. 362 (27.01%) babies required admission to NICU and major reasons for NICU admissions were prematurity, birth asphyxia, and septicemia. There were 84 still births and 43 early neonatal deaths. Conclusion: Twin pregnancy is associated with increasing risk to mother and foetus, therefore, all twin pregnancies should have a mandatory hospital delivery. Early diagnosis, adequate antenatal, intra-natal and postnatal cares are necessary to improve outcome.