Abstract
Twin pregnancies remain a major health problem given the increased incidences of both maternal and foetal complications in the country. This study provides relevant clinical and public health information that will help the clinicians on how to manage multiple pregnancies and prevent complications. 1. To determine maternal complications in multifetal pregnancy; 2. To determine the foetal and postnatal outcomes in multifetal pregnancy.Research approach and design -A Prospective and Retrospective Cohort study.Department of Obstetrics and Gynaecology, Amala Institute of Medical Sciences Thrissur, Kerala. All antenatal patients satisfying the inclusion criteria were included in the study. The incidence of multifetal pregnancy was 1.55% in our institution. Preterm labour complicated 25.6% of multiple pregnancies, 4.3% were complicated by abruptio placentae and 0.9% were complicated by placenta praevia. Gestational hypertension complicated 12% of pregnancies. Majority (55.6%) were delivered by LSCS, whereas 39.2% delivered vaginally and 5.2% had operative vaginal deliveries. Postpartum haemorrhage complicated 17.9% of twin deliveries. The incidence of prematurity among babies of multiple pregnancy was 53%. The total fetal loss was 3.4%. There was no maternal mortality in our study.Multiple pregnancies had a higher likelihood of adverse maternal and perinatal outcomes than singleton pregnancies. Mothers carrying multifetal pregnancy should be properly counselled regarding all the complications and should be kept under constant monitoring.
Highlights
Twin pregnancies had by itself a very prominent place in human mythology since ancient times
As for the incidence of multiple pregnancy with regards to the parity, we found that the highest incidence was among primigravidae (62.4%) and the least was in multi para with parity more than 3 (0.9%)
Four of our subjects showed a positive family history, none of them had a past history of multiple pregnancy
Summary
Twin pregnancies had by itself a very prominent place in human mythology since ancient times. Throughout the world, the prevalence of twin pregnancies varies from approximately 2-20 /1000 live births. Gestation rates can be explained by the social shift in women’s attitude regarding child bearing which has resulted in more women choosing to postpone child bearing in favour of work and career commitments This delayed childbearing has resulted in an increased maternal age at conception, which in turn lead to infertility treatment such as ovulation induction, in vitro fertilization and intra cytoplasmic sperm injection as one of the predisposing factors of twin gestation, since fertility decreases with age. Maternal mortality associated with multiple pregnancy is 2.5 times that for singleton births. Vigilant obstetric care decreases the maternal morbidity and mortality and helps to improves the fetal outcome
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