STUDY TO DETERMINE THE PERINATAL MORTALITY AMONG TWIN BORN BABIES

Objectives: To determine the frequency causes and perinatal mortality rate in twins. To determine that 2nd born twins contribute more to perinatal mortality than 1st born twins. Study design: A descriptive, analytical. Place and duration: In the Obstetrics and Gynecology Unit I of Nishter Hospital Multan for six months duration from September 2019 to February 2020. Methodology: The study included twin pregnancy that resulted in perinatal death of both or one of them. Causes of mortality were described on the basis of the ICD-9 revision. Mortality was assessed on the basis of gestational age, body weight, fetal appearance and route of delivery. Collected data was analyzed on SPSS-18. Results: In total, 1970 deliveries were made during the period under review, including 47 deliveries of twins. The incidence of twins was 23/1000 cases and perinatal mortality was 308/1000 cases of twin births. Deaths in the perinatal period caused 18 twin pregnancies in twins or both twins. There were 7 (38.8%) dead births in 2nd birth and 4 (22.2%) in 1st birth twins. Intra-labor anoxia resulted in 5 (27.7%) dead births in 2nd and 2 twins (II.1%) first twins. Birth hypoxia syndrome and respiratory distress syndrome were the main causes of neonatal mortality in 7 (38.8%), 2 (11%) of the first twins and 5 (27.7%), 4 (16.6%) of the second twins respectively. During pregnancy 5 (27.7%) miscarriages of dead twins 2 and 2 (II%) of the first weight of twins> 2.5 kg were found. Maximum neonatal mortality was 4 (22.2%) between 1.0-1.49 kg at first birth and 5 (27.7%) in second-year twins between 1.5-1.99 kg. Caesarean section due to incorrect presentation was performed in 5 (27.7%) dead miscarriages 2 and 2 (11%) in the first twins. The fetuses with the head and castle presentation provided by the vagina caused the death of newborns 5 (27.7%), 3 (166.6) of the first twin and 3 (166.6%), 4 (22.2%) of the second twin, respectively. Conclusion: There was no significant difference in mortality in twins one and two years old. However, during pregnancy, stillbirths were more common in twins of the second century. In contrast, prematurity complications contributed to an equal number of neonatal deaths in both twins. KEYWORDS: twin pregnancy, perinatal mortality, stillbirth, neonatal death