English

Abstract

BACKGROUND Twin pregnancy is associated with a high risk of maternal morbidity and mortality. Gestational hypertension, preterm labour, preterm premature rupture of the membranes (PPROM), and postpartum haemorrhage (PPH) are higher in twins. However, little is known about the differences in maternal risks in monochorionic and dichorionic twins. We wanted to study the effect of chorionicity on maternal complications. METHODS A prospective, descriptive study was conducted in the Department of Obstetrics and Gynaecology, TDMC, Alappuzha for eighteen months. All patients with twin pregnancies admitted to TDMC, Alappuzha with gestational age of more than 24 weeks were included in the study. RESULTS The incidence of twin pregnancy was 1.5 %. The incidence of monochorionic twins was 38.7 % and dichorionic twins was 61.3 %. Preterm labour was the commonest complication in both monochorionic and dichorionic twins and the incidences were comparable. Maternal pyrexia, UTI, PPH and postpartum depression were the common maternal morbidities encountered in both groups. The incidence of PPH was 10 % in monochorionic twin pregnancies and 5 % in dichorionic twin pregnancies. Maternal bed days for dichorionic twins were higher than monochorionic twins. CONCLUSIONS Preterm labour was the commonest complication in both types of twins with comparable incidence. Gestational hypertension was the second common complication in both. Caesarean section rate was higher in dichorionic twins than monochorionic twins i.e., 63 vs. 41.5. Maternal pyrexia was found in 12 % of cases, the most common postpartum morbidity. Mean maternal bed days for dichorionic twins were found to be higher than monochorionic twins.13.4 vs. 8.85. KEY WORDS Twins, Monochorionic, Dichorionic, Maternal Morbidity.