Abstract
Objective: To determine the perinatal outcome of twin pregnancy and to find out the frequency of twin deliveries in hospital based population.
 Study Design: Descriptive case series.
 Place and Duration of Study: The study was conducted over a period of 02 Year 1st January 2018 to 31st December 2019 in the Obstetrics and Gynaecology Department at KMC Khairpur Mirs, Sindh Pakistan.
 Methodology: All the patients of age 20-35 years with twin pregnancies of gestational age above 30 weeks presenting in labour ward of KMC Khairpur Mirs were studied. A detailed history was taken, general physical (G.P) examination and obstetrical examination performed, targeted investigations carried out to detect various fetal complications. Patients were assessed for a mode of delivery, records for data like age, gestational age, weight of baby, APGAR score expressed in term of mean±SD and data like perinatal mortality, prematurity, intra uterine growth restriction (IUGR), the weight of baby and APGAR score expressed in terms of frequencies and percentages on SPSS version 20.
 Results: In this study total numbers of deliveries were 7200, among them 83 were twin pregnancies the frequency of twin was 1.15%. Booked cases were 24.1%, unbooked was 75.9%. The highest incidence of 42.2% of twin gestation was seen in women between ages 31-35 years, the mean age of patients was seen 30.1±4.1 and regarding the parity incidence was high 54.2% in multiparous l-5. The total number of preterm deliveries was 45(55.2%), gestational age was (35-36+6dnys) weeks in 22.89% of cases, and the mean gestational age of patients was 35.7±2.5. Perinatal mortality was 38(22.9%), stillborn and early neonatal deaths (ENND) were 18.4% and 36.8% and common in twin-2.
 Conclusion: Twin pregnancy is-a-high-risk-pregnancy still is a major obstetrical and perinatal challenge. The frequency of twin pregnancy seen in this study is 1.15% unbooked and unsupervised pregnancies are more common i.e 75.9%. Prematurity is common perinatal morbidity 51.20%. perinatal mortality is 22.9% and highest in twin-2.
Highlights
Twin pregnancy is considered high-risk pregnancy because perinatal mortality and morbidity in twin are higher as compared to singletons, mainly caused by low birth weight and prematurity, twin -twin transfusion syndrome and by mal-presentation and mode of delivery [1]
Multiple gestations are associated with increased complications in utero as compared to singleton gestation, with an increased reported incidence of early pregnancy loss, congenital anomalies, intrauterine demise, TIJGR, prematurity, low birth weight, Monochorioncity increases the risk of adverse perinatal outcome whereas the effect of zygosity is less clear [3]
Data will be analyzed by SPSS version 20.0 numerical data like gestational age, perinatal mortality, prematurity, intrauterine growth restriction, weight of baby and APGAR score was expressed in terms of frequencies and percentages. 95% confidence interval will be computed for all outcome of interest
Summary
Twin pregnancy is considered high-risk pregnancy because perinatal mortality and morbidity in twin are higher as compared to singletons, mainly caused by low birth weight and prematurity, twin -twin transfusion syndrome and by mal-presentation and mode of delivery [1]. Multiple gestations are associated with increased complications in utero as compared to singleton gestation, with an increased reported incidence of early pregnancy loss, congenital anomalies, intrauterine demise, TIJGR, prematurity, low birth weight, Monochorioncity increases the risk of adverse perinatal outcome whereas the effect of zygosity is less clear [3]. Twin are dizgostic (dizygous, binovular, fraternal or non identical) result from the fertilization of two independently released ova by two different sperms. All these twins are dichorionic and diamniotic. The considerable geographical and temporal variation influence the incidence of dizygotic or non-identical twins, twining occurs fr m 4/1000 births in Japan to 54/1000 in Nigeria and common in older mothers due to their rising FSH, in contrast monozygous occurs with constant incidence of 3.9/1000, the twinning rate in UK is from 9.8 to 14.7/1000 maternities, increase in incidence due to Assisted reproductive technique (ART) [5,6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
