Perinatal outcome in twin pregnancy according to chorionicity

This study was a prospective study conducted on 100 twin pregnancies. The study was conducted at the Institute of Social Obstetrics, Government Kasturba Gandhi Hospital between December 2012 to November 2013. AIM: To assess the morbidity and mortality of twins in relation to chorionicity and to analyse the factors responsible for that. MATERIAL AND METHODS: The information pertaining to the study like age, parity, gravida, residence, family history of twin pregnancy was obtained from the patients. Chorionicity was assessed using ultrasound and placental examination. The perinatal outcome was recorded in terms of gestational age at delivery ( 28 – 30 weeks, 31-33, 34-37, > 37 weeks), mode of delivery (Caesarian section/vaginal delivery/combined/outlet forceps/vacuum), Apgar score at 0 and 5 mins, birth weight(> 2500 gms, 2500 – 1500 gms, < 1500 gms), gender, dead/still/alive, babies getting admitted to NICU, number of days in ICU, and the final outcome of the babies, in terms of whether the baby got discharged in good condition or expired. RESULTS: Among the 100 twin pregnancies, 62% were dichorionic diamniotic, 34% were monochorionic diamniotic and 4% were monochorionic and monoamniotic. Primigravidas constituted for 43% of pregnancies and multigravidas constituted for 57%. In both mono and dichorionic pregnancies the common age group was 25 – 29 years. Of the maternal antepartum complications, preeclampsia ranked first which was present in about 25%, anemia occurred in 20%, GDM in 4% and APH in 3% and hydramnios in 1% out of the 100 twin deliveries. The mean gestational age of delivery for MCDA was 33 weeks compared to DCDA which was 34 weeks. PPH was present in 21% of MCDA and 16% of DCDA. Of the specific complication in relation to chorionicity, the incidence of IUD, selective IUGR , congenital anomalies ,discordant growth were more in MCDA. Still birth rate was equal in both. The fetal outcome in terms of NICU admission, number of twins expired, apgar score