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Study of neonatal outcome in multiple gestation

Garima Girish Arora, Gourav Rajendrasingh Bagga, Girish C. Arora.

Abstract
Background: Development of more than one fetus inside the uterus is called multifetal gestation or multiple pregnancy. Itís a great challenge to the concerned obstetricians, due to late diagnosis and related complications. The main causes of perinatal mortality are prematurity, congenital defects, malpresentations, placental insufficiency and traumatic deliveries. Therefore understanding of twinning phenomenon is needed to improve perinatal outcome of this high risk pregnancy. The aims and objectives were to study fetal outcome in patients with multiple gestation.
Methods: A prospective observational study carried out during the period of 1 year. A total of 200 patients with antenatal clinical and ultrasound confirmed diagnosis of multiple gestation were enrolled for the study. After taking proper consent for the study, proper history, clinical and obstetrical examinations were conducted and findings noted. Mothers and neonates were followed till discharge from the hospital.
Results: Most common presentation was vertex of both foetuses (62.63%). 70.14% patients underwent spontaneous vaginal delivery and 20.32% underwent LSCS with malpresentation being the most common indication of LSCS. 40.70% patients delivered foetuses of opposite sex. 78.89% had dichorionic and diamniotic placenta. 78.89% had binovular twins. 33.66% foetuses had birth weight between 1.6 to 2 kgs (low birth weight). Prematurity was the most common fetal complication (34.91%). Total perinatal mortality rate is 14.21%. Prematurity was most common cause of neonatal mortality. 6.73% are still birth rate. IUGR was the most common cause of still births.
Conclusions: Multiple gestation is a mixed blessing and if successful, allows a couple to rapidly expand their family with a minimum number of pregnancies but itís a great challenge to the concerned obstetricians. Complications due to multiple gestation are associated with adverse maternal outcome.

Key words: Multifetal gestation, Multiple pregnancy, Neonatal outcome, Neonatal mortality, Perinatal mortality, Still birth



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