Maternal and Perinatal Outcome in Multifetal Pregnancy: A Study at a Teaching Hospital

Abstract

Multiple pregnancies are associated with adverse maternal and neonatal outcomes as compared to singleton pregnancy. This study was conducted to determine the maternal and perinatal outcomes in multifetal pregnancy at a teaching hospital in western region of Nepal. It was a prospective observational study. It was conducted in the department of obstetrics and gynecology, Manipal Teaching Hospital, Pokhara, from January 2012 to December 2014. This study included data on all women admitted between January 2012 to December 2014 with 28 completed weeks gestation having multifetal pregnancies in labor during the above mentioned period. The data was obtained from the hospital medical record department and the birth register. It included demographic details, complications of pregnancy and maternal and neonatal outcomes. The data was expressed as frequencies, percentages, and mean. There were a total of 144 multiple pregnancies who had delivered with the overall incidence of 1.9 per 1000 births during the study period. There were 5 triplet pregnancies among these. The main maternal adverse outcomes were preterm delivery (62.58%), anemia (8.6%), pregnancy induced hypertension (5%), and antepartum hemorrhage (2.2%). The mean gestational age at delivery was 34.6 weeks for twins and 33 weeks for triplets. The commonest mode of delivery was vaginal 54% of first twin and 52% of second twins whereas 3 triplets delivered by caesarean section and two delivered vaginally. The most common neonatal complication was low birth weight. The most common cause of neonatal death was prematurity with neonatal sepsis. So it was concluded that multiple pregnancy have high maternal and neonatal complications, mainly preterm delivery that increases the risk of neonatal morbidity and mortality.