European Journal of Biomedical and Pharmaceutical Sciences

STUDY ON NEONATAL OUTCOME OF TWINS ACCORDING TO BIRTH ORDER, PRESENTATION AND MODE OF DELIVERY.

Dr. Urvashi Chhikara* MS, Resident, Dr. Latika Sahu, Professor and Dr. Asmita M. Rathore, Director Professor

ABSTRACT

Management of twin pregnancy is a challenge in obstetrics. The optimum mode of delivery for twins is not determined. The objective of this study is to compare the outcome of twin pregnancies according to birth order, presentation and mode of delivery. The study included 101 patients with twin pregnancies with > 32 weeks period of gestation, with both twins live. Neonatal morbidity and mortality (death within 28 days) was compared in study group in relation to their birth order (first and second twin), presentation (vertex and non-vertex) and mode of delivery (vaginal delivery, caesarean section or combined- first twin vaginal delivery and second by caesarean section). Follow up was done for 1 month or till NICU admission of neonate. Results: Out of 101 patients, 75 were planned for vaginal delivery and 26 for caesarean section. Overall caesarean section rate was 28.7%. Neonatal morbidity in relation to birth order for first twin (28.71%) and second twin (26.7%), with p value of 0.838. Outcome in relation to presentation of first twin between vertex (29.6%) and non-vertex (26.6%) with p value of 0.768 and for second twin with p value of 0.33. For mode of delivery, vaginal delivery (31.34%), caesarean section (24.13%) and combined group (20%), with p value not statistically significant. Conclusion: With good antenatal care and intrapartum surveillance, trial of labour can be done for vaginal birth for twin pregnancies.

Keywords: Twin pregnancy, neonatal outcome, chorionicity, apgar score.