Study of birth anomalies in twin pregnancies

Abstract

Introduction: Twin pregnancies with congenital malformations in foetuses is associated with higher morbidity and mortality both for the mother as well as the child Its incidence is 4 times more common than single births. This study highlights rare anomalies and complications in twins Materials and Methods: This is a prospective study which includes women with twin pregnancies diagnosed in first trimester by sonography. The cases were collected from a maternity hospital over a period of one year. Details of gestational age, gender, zygosity, chorionicity, anomalies and complications of the twins were taken into account along with age and parity of the mother. Results: Out of 2023 pregnancies 41 were twin pregnancies in which 23 were dizygotic twins and 18 were monozygotic twins based on Weinberg formula. Congenital anomalies and fetal complications were observed in 4 cases (17.39%) of dizygotic twins and 8 cases (44.44%) of monozygotic twins. The affected twins predominantly belonged to female sex. Monozygotic twins showed TRAP Sequence with Acephaly and Twin to twin transfusion syndrome in 2 and 3 pairs respectively. Pregnant women with twins were between 25 to 40 years of age group. Conclusion: Twining rate was 20.26/1000 deliveries. Central nervous system anomalies were seen in women with no folic acid intake preconceptionly. Complications and anomalies were among monozygotic twins. Therefore chorionicity of the placenta should be detected in first trimester of pregnancy in order to prevent fetal deaths by undertaking appropriate medical measures. Keywords: Monozygotic (MZ), Dizygotic (DZ), Twin to twin transfusion syndrome, (TTTS), Twin reversed arterial perfusion, Sequence (TRAP sequence), Congenital anomalies (CAs).