Abstract
Background: Monochorionic twins showed increased incidence of discordant growth as compared to dichorionic twins. Studies have reported fivefold mortality of twins in comparison with singleton pregnancy. In this a prospective study is done to assess the perinatal, neonatal mortality and morbidity in multiple gestations. Zygosity determines the degree of risk of chromosomal abnormalities in each fetus of a multiple gestation. The risk for aneuploidy in each fetus of an MZ pregnancy is the same as a singleton pregnancy, and except for rare cases of genetic discordancy, both fetuses are affected. In a DZ pregnancy, each twin has an independent risk for aneuploidy, and therefore has twice the risk of having a chromosomal abnormality compared with a singleton.
 Material and methods: This prospective observational study was conducted in the Department of Paediatrics Darbhanga Medical College and Hospital, Darbhanga Bihar India. The time period of the study from May 2019 to feb 2020. The total number of multiple gestation 160 include in this study.
 Results: Total 160 twins were studied, out of which preterm deliveries constituted 80.6% of all deliveries. Most of the mothers were between 24 to 30 year age group 70(43.8 %) followed by 18 to 24 year 55 (34.4 %) and most of them were primi 97(60.6%) and followed by gravid 2 was 54 (33.8%). Out of 160 patients 29 patient s was family history of twining in 18.1% of the study group. Assisted reproductive techniques such as clomiphene cirate,IUI and IVF were used by 19.4% of couples. Dichorinic diamniotic twins accounted for 84.4% and Dichorinic triamniotic 2.4 % of the total multiple deliveries. Normal Vaginal delivery was done for 65.6% of twins and LSCS for 34.4%.
 Conclusion: Most common type of delivery was vaginal delivery (65.6%) followed by LSCS (34.4%).Out of the variables studied, significant influence on neonatal mortality was seen only with discordant twins
Highlights
Twin pregnancies account for 2 to 4% of the total number of births.[1,2,3,4,5,6] Spontaneous twin pregnancy rates vary worldwide
Zygosity determines the degree of risk of chromosomal abnormalities in each fetus of a multiple gestation
In a DZ pregnancy, each twin has an independent risk for aneuploidy, and has twice the risk of having a chromosomal abnormality compared with a singleton
Summary
Twin pregnancies account for 2 to 4% of the total number of births.[1,2,3,4,5,6] Spontaneous twin pregnancy rates vary worldwide. The few existing studies have methodological limitations, and a small number of cases.[1,2,3,11] Studies on mortality and morbidity are rare, but even rarer are studies that associate twin pregnancy with the new concepts of severe maternal outcome (SMO) and maternal near-miss (MNM). Studies have reported fivefold mortality of twins in comparison with singleton pregnancy. In this a prospective study is done to assess the perinatal, neonatal mortality and morbidity in multiple gestations. Out of 160 patients 29 patient s was family history of twining in 18.1% of the study group Assisted reproductive techniques such as clomiphene cirate,IUI and IVF were used by 19.4% of couples. Conclusion: Most common type of delivery was vaginal delivery (65.6%) followed by LSCS (34.4%).Out of the variables studied, significant influence on neonatal mortality was seen only with discordant twins
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