Publication:

Fetomaternal outcome in multiple pregnancy

Background Multiple pregnancies are more common in recent days than in the past. Increased maternal age at conception due to delayed childbearing trend has resulted in multifetal gestations. Twin gestation imposes greater demand on the maternal physiological system than does singleton pregnancy. The incidence of multifetal gestation has increased mainly because of advanced maternal age and assisted reproductive technology. Multiple pregnancy is considered as high-risk pregnancy as it contributes significantly to adverse maternal and perinatal outcomes.

Methods In this prospective observational study conducted in obstetrics and gynaecology department VMKVMCH, Salem for 6 months period, around 50 cases of multiple pregnancy were taken into consideration and patients were followed up from admission till delivery and neonatal outcome analysed. Main outcome measures were maternal complications (anaemia, pre-eclampsia, post-partum hemorrhage, gestational diabetes mellitus (GDM), perinatal mortality and morbidity.

Results Higher incidence of twin gestation was noted between the age group of 20-25 years and maximum were of spontaneous conception. None of them had family history of twins or past history of the same. We noted that maximum were preterm deliveries and majority of the patients underwent lower segment caesarean section (LSCS). Twin specific complications were noted according to their chorionicity. Most of the babies weighed between 1.5-2.5 kg. Perinatal mortality was 7.5% and no maternal mortality noted.

Conclusions The knowledge of maternal and fetal risks associated with multiple gestation helps in prevention of adverse outcome and better surveillance.