Research Paper

A CLINICAL STUDY ON PREGNANCY OUTCOME IN MULTIFETAL GESTATION

  Abstract :

In india,twin pregnancies are classified into two groups,one arising spontaneously and the other arising due to assisted reproductive technologies.Rate of twinning varies with race,heredity,maternal age,parity,nutrition,levels of endogenous hormones.Various maternal risks associated with multiple pregnancy include anaemia,hydraminos,PIH,preterm labour ,PPH etc.On the other hand ,the fetal complications include stillbirth,congenital anomalies,twin to twin transfusion syndrome,twin entrapment,twin interlocking etc.Incidence of anaemia is increased to approximately 40% and that of PIH to 26%.Looking at the perinatal mortality,the mortality of twin 2 is more than that of twin 1.During labour,the total duration of labour is similar to singleton gestation.The method of delivery dpends upon the number of fetuses,presentation of the first fetus and gestational age.Multiple gestations account for about 17%of the growth restriction.Prematurity rather than ntrauterine growth restriction exerts the dominant effect on birth weight and accounts as the main cause of perinatal mortality.The timing of delivery of the second twin also plays an important role.Mortality rates are higher in primis and lower in multigravidas.Labour natural and LSCS have a better outcome than other methods.Birth weight of the babies is the most important factor that determines the perinatal outcome.Ultrasound evaluation is the single most important diagnostic test in multiple gestation.COONCLUSION:Early detection of maternal complications and its management will improve outcome.Immediate neonatal intensive care contributes to improved perinatal and neonatal outcome.Hence women with multiple gestation should ideally receive antenatal care in special twin clinics.The twin clinic should also provide a strucutured plan that will enable early detection and effective management of antenatal,intrapartum and postnatal needs of the parets.Twin clinics can also provide a base for what has been an under-researched aspect of obstetrics.

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