A Prospective study on Maternal and Perinatal Outcome in Multiple Pregnancy

200 multiple pregnancy cases were studied in our institute, out of which 98% of the cases were booked, 61% of them are primi gravida and 39% of them were multigravida. 78% of them delivered at an gestational age less than 36 weeks, preterm delivery. 71% of them conceived spontaneously and 29% conceived after assisted reproductive techniques out of which, 19% were out of IVF conception. 63% of them were DCDA, 29% were of MCDA, 4% were MCMA, 3.5% of them were TCTA. ❖ Various maternal complications and its percentage associated with multiple pregnancy among them, preterm delivery is the most common complication about 62%, and the second one is postpartum hemorrhage 22.5%. Followed by anemia 20%, other rare complications include single fetal demise,fetal growth restriction weighs about 4.5% and 5.5% respectively, though it is rare it is specific for multiple pregnancy. ❖ Cesarean mode of delivery is the most common mode of delivery when it comes to multiple pregnancy, which accounts for 63%. ❖ Among indications for cesarean deliveries, non cephalic presentation of first twin pose the major threat to increase the primary cesarean section rate, followed by fetal distress, all the 6 TCTA triplets were delivered by cesarean mode of delivery keeping in mind the prematurity of the fetuses and most of them had growth restriction. ❖ From our study it is evident that birth weight of twin babies mostly fall in the range of 2.1 to 2.5 this can be extrapolated to the preterm nature of the babies of multiple pregnancy. ❖ With regards to APGAR, 5 minute apgar less than 8 was found in 89% of twin 1 and 91% of twin 2 and 100% of triplet 3. ❖ Among neonatal complications, 5 minute apgar less than 8 was found in 89% of twin 1 and 91% of twin 2 and 100% of triplet 3. 51% of babies had NICU admissions the number were quite large when compared to singleton pregnancy and 5.5 % babies had birth asphyxia and 4% of the admitted babies developed neonatal seizures and 3.5% babies developed sepsis CONCLUSION: A dramatic increase in the numbers of multiple births in developed countries has stimulated interest in the progress and outcome of such pregnancies. As well as considerable health risks, the social, psychological and financial impact of multiple births, especially higher order multiple births, has been highlighted. ❖ This study revealed higher percentage preterm labour, anemia, gestational hypertension in twin pregnancy as compared to other studies. Anaemia, hypertensive disorder of pregnancy along with postpartum haemorrhage are the well-known causes of maternal mortality, thus frequent antenatal visits should be aimed to detects maternal complications earlier. Aggressive treatment of anemia with intravenous iron should be considered whenever there are adverse effects or noncompliance to oral iron. Atonic postpartum haemorrhage should be anticipated in all multiple pregnancies, therefore prophylactic treatment should be prearranged for its prevention