Maternal and neonatal outcomes in twin pregnancy at a tertiary care center

Background: Multiple gestations are on the increase globally due to several factors, the most important being the use of assisted reproductive technology (ART).Multiple pregnancy has substantially higher risk of fetal morbidity and mortality compared to singleton pregnancies.Twin pregnancies constitute 2 to 4% of total number of births.Perinatal mortality rates are four fold higher for twins than for singletons.Twin gestations are at increased risk of a variety of pregnancy complications, which can be minimized by antepartum diagnosis and management.Objective of the study is to evaluate maternal and neonatal outcomes associated with twin pregnancies in a tertiary care center of Tamil Nadu.Methods: This observational study was conducted in the Department of Obstetrics and Gynecology from the period of January 2021 to December 2021.The study included 50 women with twin pregnancies with gestational age of 28 weeks or more.Maternal and neonatal outcomes were studied.Results: Incidence of twin pregnancy was found to be 2.08%.Twins were more in multigravida (78%) as compared to primigravida (22%), with maximum incidence between the age group of 20 to 29 years.Maximum (72%) women delivered between the gestational age 29 to 37 weeks.Most common fetal presentation was vertex -vertex presentation (54%).The most common maternal complication in twin pregnancy was preterm labour (48%), followed by anemia in 34% women and hypertensive disorders (30%) and gestational diabetes mellitus (30%).Most common mode of delivery was by caesarean section (72%) and most common indication being malpresentation.Most common perinatal complication was prematurity (52%), followed by respiratory distress (46%), fetal growth restriction (20%), hyperbilirubinemia (11%) and neonatal sepsis (10%).NICU admissions were 62%.There was no maternal mortality reported in this study and 1% perinatal mortality in NICU admitted neonates.Conclusion: Twin pregnancies are associated with significant maternal and perinatal risks, especially for the second twin.Early diagnosis is important for proper counseling and timely management so as to optimize maternal and perinatal outcome.