Twin Pregnancy and the Effects of Prophylactic Leave of Absence on Pregnancy Duration and Birth Weight

Objective: To determine the socio demographic characteristics, clinical presentation and obstetric outcome at delivery and immediate postpartum period of twin gestation in a periurban hospitalMaterial & Methods: An observational study was conducted between January 2000 to December 2004 at Institute of Child and Mother Health. All twin pregnancy irrespective of gestational age admitted in the in-patient department of Institute of Child and Mother Health for delivery and also those undiagnosed cases found to have twin birth were enrolled in the study consecutively from January 2001 to December 2004. Data on socio-demographic factors, predisposing factors for twin gestation and obstetric characteristics was collected using a structured questionnaire. Hospital records were consulted for recording the investigation reports and management options. The outcome variables were maternal complications during antenatal, intranatal and immediate postnatal period, mode of delivery, birth weight and sex of newborn and fetal outcome. All twin pregnancies from the admitted obstetric patients were enrolled consecutivelyResults: During the study period there were 11,185 deliveries and among them 107 were twin gestation. About 22% were primigravida, 78.5% multigravida, 27.1% were illiterate. Most common age group were 24-29 years (39.4%). Antenatal care was availed by 71% of patients and 27.1% twins were not diagnosed till delivery. Family history of twin on maternal side was present in 58.1% and 31.8% had history of taking oral contraceptive immediately before the pregnancy. Ovulation inducing agents were given to 8.3% of twin. Presentations of fetus were both vertex 54.2%, 1st vertex and second breech 16%, and both breech 5.7%. About 55.1% were admitted with labor pain, 6.5% were undelivered second twin. Preterm birth was 27.2% and low birth weight of 1st baby 79.6% and second baby 80.9% respectively. Mode of delivery was vaginal delivery of both fetus 41.6%, caesarean section of both fetus 62.4%, and caesarean for second twin 3.1%. Same sex of both twins was found in 78% and male-male pair was 50%. There was one stillbirth, one conjoined twin and perinatal death was 11.2% Complications encountered during perinatal period were severe abdominal pain 9.3%, retained placenta in 7.3%; and post partum hemorrhage in 4.6% cases.Conclusion: Twin pregnancy is quite common and warrants specialized care during ante partum, intrapartum and postpartum period.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 57-62

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"Neonatal Hepatitis" in Twin Pregnancy

PEDIATRICS ◽

10.1542/peds.36.1.138 ◽

1965 ◽

Vol 36 (1) ◽

pp. 138-140

Author(s):

PAUL W. K. WONG ◽

RICHARD C. BURNSTINE ◽

DAVID YI-YUNG HSIA

Keyword(s):

Case Report ◽

Weight Gain ◽

Birth Weight ◽

Twin Pregnancy ◽

Memorial Hospital ◽

Neonatal Hepatitis ◽

White Female ◽

Dizygotic Twins ◽

History Of

The familial nature of "neonatal hepatitis" has been known far some years. The present paper reports on the occurrence of this condition in one of dizygotic twins. Case Report A.B., a white female, was first admitted to the Children's Memorial Hospital at the age of 2 months with a history of persistent jaundice. She was the first born of a twin pregnancy with a birth weight of 5 lb (2.3 kg). Jaundice was first noted within a few hours after birth and increased in intensity as the child grew older. The stools were light and the urine dark. Despite a good appetite, the weight gain had been poor.

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Perinatal mortality in twin pregnancy: An analysis of birth weight-specific mortality rates and adjusted mortality rates for birth weight distributions

Journal of Perinatal Medicine ◽

10.1515/jpme.1988.16.2.85 ◽

1988 ◽

Vol 16 (2) ◽

pp. 85-92 ◽

Cited By ~ 21

Author(s):

Ernesto Fabre ◽

Rafael González de Agüero ◽

Jose Luis de Agustin ◽

Maria Pilar Pérez-Hiraldo ◽

Jose Luis Bescos

Keyword(s):

Birth Weight ◽

Perinatal Mortality ◽

Twin Pregnancy ◽

Mortality Rates ◽

Weight Distributions ◽

Specific Mortality

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The Relationship Between Gestational Age and Birth-Weight in Twin Pregnancy

Australian and New Zealand Journal of Obstetrics and Gynaecology ◽

10.1111/j.1479-828x.1984.tb01488.x ◽

1984 ◽

Vol 24 (3) ◽

pp. 192-197 ◽

Cited By ~ 5

Author(s):

John R. Fliegner ◽

Thomas R. Eggers

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Twin Pregnancy ◽

The Relationship

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NEC in Twin Pregnancies: Incidence and Outcomes

Journal of Neonatal Surgery ◽

10.47338/jns.v3.135 ◽

2014 ◽

Vol 3 (4) ◽

Author(s):

Sathyaprasad C Burjonrappa ◽

Brian Shea ◽

Diya Goorah

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Medical Records ◽

Lead Time ◽

Twin Pregnancy ◽

Antenatal Screening ◽

Singleton Pregnancy ◽

Average Lead ◽

Gastrointestinal Emergency ◽

Twin Pregnancies

Background: Necrotizing Enterocolitis (NEC) is the most common gastrointestinal emergency in neonates. Previously established risk factors for the development of NEC include prematurity and low birth weight. However, it is not clear to date as to whether the etiology of NEC is due to host, environmental, or yet other unknown factors. We analyzed the differences in incidence of NEC in twin pregnancies to further clarify its etio-pathogenesis.Methods: After IRB approval, a retrospective search of the medical records of the Department of Pediatric Surgery was done to identify all the neonates treated for surgical NEC from 2006-2013. Patients that had been treated for NEC elsewhere and subsequently transferred in to our facility were excluded. The medical records of the resulting 45 patients were then analyzed for demographics, antenatal screening, risk factors, treatment (medical and surgical), and outcomes. The resulting data was then analyzed using relative risk calculations and standard statistical tests.Results: Of the 45 patients who developed surgical NEC, 9 neonates (20%) were born of a twin pregnancy. There were no cases in which both twin A and twin B developed NEC. NEC in twin pregnancy neonates showed a female preponderance (p<0.0001) and developed universally in the first born of the twins. Birth weight, time of onset of NEC, hospital stay and mortality were similar between twin and non-twin NEC. There was an average lead-time of three weeks to development of NEC in both singletons and twin pregnancies.Conclusion: There is a remarkable higher incidence of NEC amongst twins. Abnormal colonization of the gastrointestinal tract appears to be an immediate postpartum event. NEC in twin pregnancy does not appear to have a deleterious outcome compared to NEC in singleton pregnancy.

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Bed Rest in Twin Pregnancy

Acta geneticae medicae et gemellologiae twin research ◽

10.1017/s0001566000004931 ◽

1985 ◽

Vol 34 (1-2) ◽

pp. 67-71 ◽

Cited By ~ 2

Author(s):

B. Kappel ◽

K.B. Hansen ◽

J. Moller ◽

J. Faaborg-Andersen

Keyword(s):

Birth Weight ◽

Preterm Delivery ◽

Gestational Age ◽

Twin Pregnancy ◽

Bed Rest ◽

Fetal Weight ◽

Reduced Frequency ◽

Twin Pregnancies ◽

At Home

AbstractA total of 146 twin pregnancies were studied to evaluate the importance of bed rest. A significantly reduced frequency of preterm delivery was found after bed rest in hospital as compared to bed rest at home or no bed rest at all. An increase in gestational age and in birth weight was seen after bed rest. No effect was found on the intrauterine increase of fetal weight per time. Early routine ultrasound is recommended, so that effective bed rest may be instituted in due time.

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Diagnostic accuracy of ultrasound in predicting birth-weight discordance in twin pregnancy: systematic review and meta-analysis

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.17348 ◽

2017 ◽

Vol 50 (4) ◽

pp. 442-450 ◽

Cited By ~ 11

Author(s):

M. Leombroni ◽

M. Liberati ◽

F. Fanfani ◽

G. Pagani ◽

A. Familiari ◽

...

Keyword(s):

Systematic Review ◽

Birth Weight ◽

Diagnostic Accuracy ◽

Twin Pregnancy ◽

Meta Analysis

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Drug Closure of a Patent Ductus Arteriosus in An Extremely Low Birth Weight Premature Newborn. A Case Report

The Journal of Critical Care Medicine ◽

10.1515/jccm-2015-0006 ◽

2015 ◽

Vol 1 (1) ◽

pp. 28-32 ◽

Cited By ~ 1

Author(s):

Elena Moldovan ◽

Manuela Cucerea

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Patent Ductus Arteriosus ◽

Twin Pregnancy ◽

Ductus Arteriosus ◽

Smooth Muscles ◽

Specific Treatment ◽

Extremely Low Birth Weight ◽

Premature Newborn ◽

Patent Ductus

Abstract Introduction: Patent ductus arteriosus involves maintaining the permeability of the vascular ductus located between the pulmonary artery and the descending aorta, due to the failure of transition from foetal to adult type circulation. This malformation is characteristic to premature newborns with extremely low birth weight. The main pathophysiological factors identified in this pathology are immaturity of the smooth muscles, presence of vasodilator mediators and persistent hypoxaemia. Ductal-dependent cardiac malformations require drug therapy for keeping the permeability of the ductus arteriosus until the time of corrective surgery. Case presentation: We present the case of an extremely low birth weight premature newborn, derived from twin pregnancy with suspected specific pathology, respectively feto-fetal transfusion syndrome, admitted to the Regional Centre of Neonatal Intensive Care Unit Tîrgu-Mureş. Premature newborn with gestational age 31-32 weeks, extremely low birth weight, derived from twin pregnancy, with adequate prenatal follow up, was born by caesarean section for severe intrauterine growth restriction secondary to feto-fetal transfusion syndrome suspicion. The newborn developed respiratory distress syndrome by surfactant deficiency, intraventricular-haemorrhage grade I/II, and severe retinopathy. The detection of a systolic murmur in the second week of life, the diastolic theft revealed by trans-fontanellar ultrasound as well as lowered diastolic blood pressure values raised the suspicion of a patent ductus arteriosus and therefore specific treatment with ibuprofen, a cyclooxygenase inhibitor, was initiated. Progressive alteration of the newborn's condition and the evidence of a coarctation of the aorta imposed the initiation of Prostaglandin E1 therapy and subsequent surgical correction. Conclusions: Although beneficial, prophylactic or therapeutic closure of persistent ductus arteriosus

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A 1 year Study on Pattern of Neonatal Admissions and Mortality Related to Neonatal and Maternal Influences in A Tertiary Care Teaching Hospital of Barishal

Dhaka Shishu (Children) Hospital Journal ◽

10.3329/dshj.v36i1.52637 ◽

2021 ◽

Vol 36 (1) ◽

pp. 52-60

Author(s):

Joyita Barua ◽

Sudipta Deb Nath ◽

M Monir Hossain

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Neonatal Sepsis ◽

Congenital Anomalies ◽

Twin Pregnancy ◽

Neonatal Jaundice ◽

Tertiary Care ◽

Questionnaire Data ◽

Maternal Influences ◽

Morbid Conditions

Background: Morbid conditions during the neonatal period possess a serious risk to the health and well-being of the baby. The death rate among neonates is very high in Bangladesh and various factors are responsible for this other than neonatal diseases. Objectives: The objective was to compare different aspects of neonatal conditions in a tertiary care teaching hospital and to inspect the effects of neonatal/maternal influences over neonatal morbidity and mortality. Another primary goal was to study if there was any interconnection between neonatal morbid conditions and mortality. Methods: This prospective study was carried out at Special Care Neonatal Unit of Sher-e-Bangla Medical College and Hospital, Barishal from April 2019 to March 2020. A total of 142 mothers were enquired according to our questionnaire. Data about both mothers and neonates were included in the questionnaire. Data were analyzed by using SPSS version 26. Results: A total of 142 mothers and their 150 admitted neonates were included in our cohort. Among 150 neonates, we analyzed 133 and excluded 17. During the hospital stay, 9.8% of 133 neonates died. Mortality and morbidity were dependent on factors like gestational age, birth weight, and twin pregnancy. The causes of admission were PNA with HIE (58.6%), neonatal sepsis (28.6%), neonatal jaundice (9.8%), congenital anomalies (8.3%), RDS (4.5%), IUGR (3.8%), pneumonia (2.3%), and diabetes mellitus (0.8%). Neonates having PNA with HIE showed significant p-value when correlated with the cause of LUCS- oligohydramnios, gestational age, birth weight. Pre-term neonates had substantial cases of RDS (9.8%). Neonatal sepsis was observed more on the initiation of breastfeeding on the first day (39.1%) than later (23%), and oligohydramnios, less fetal movement, prolonged labor were found to be significant causes of it. Conclusion: The study acknowledged LBW, PNA with HIE, sepsis, neonatal jaundice, congenital anomalies, and RDS as the major factors for neonatal admissions, and reasons behind mortality were LBW, prematurity, and twin pregnancy. Awareness among parents and improved infrastructure of the hospital might be helpful to reduce the gravity of the condition in the future. DS (Child) H J 2020; 36(1) : 52-60

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