scholarly journals Outcome of Twin Pregnancy in a Periurban Hospital

2016 ◽  
Vol 27 (2) ◽  
pp. 57-62
Author(s):  
Saria Tasnim ◽  
FM Anamul Haque ◽  
Sameena Chowdhury
Keyword(s):  
Birth Weight ◽  
Twin Pregnancy ◽  
Perinatal Death ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Labor Pain ◽  
Maternal Complications ◽  
Management Options ◽  
History Of ◽  
Second Twin

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

scholarly journals Twin pregnancy in each half of a didelphys uterus with delayed delivery and review of literature

2015 ◽  
Vol 0 (0) ◽  
pp. 1-4
Author(s):  
Galya Levy ◽  
Nicolas Mottet ◽  
Marianne Fourel ◽  
Anne-Sarah Tholozan ◽  
Astrid Eckman ◽  
...  
Keyword(s):  
Twin Pregnancy ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Fetal Lung ◽  
Incomplete Fusion ◽  
Class Iii ◽  
Mullerian Ducts ◽  
Risk Patients ◽  
The Right ◽  
Second Twin

Abstract Didelphys uterus results from an incomplete fusion of mullerian ducts and corresponds to the class III of mullerian abnormalities of the American Fertility Society. We describe the case of a spontaneous twin pregnancy developed in each cavity of a didelphys uterus. At 29 weeks of gestation and 6 days, the patient had preterm rupture of membranes in the right horn. She went into spontaneous labor and delivered vaginally the first “right” twin. Delivery was complicated with post-partum hemorrhage on uterine atonia treated with a Bakri balloon. She was tocolyzed to pursue the fetal lung maturity of the second twin. She had a rupture of the second membranes at 30 weeks and 3 days and had a preterm vaginal delivery at 32 weeks and 1 day of the second twin. Twin pregnancy in both horns of a uterus is extremely rare, about 1 in 1,000,000. Pregnancies on congenital abnormalities of the paramesonephric duct present frequently poor obstetrical outcomes and many complications. There are no guidelines about the follow-up of these high-risk patients or the mode of delivery.

scholarly journals Study of fetomaternal outcome in twin pregnancy

2019 ◽  
Vol 8 (12) ◽  
pp. 4762
Author(s):  
Bijal D. Rami ◽  
Somika Kaul
Keyword(s):  
High Risk ◽  
Twin Pregnancy ◽  
Post Partum ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
High Risk Pregnancy ◽  
Maternal Complications ◽  
Lower Segment Cesarean Section ◽  
Risk Pregnancy ◽  
Fetal Complications

Background: Twin pregnancy being one of the causes of high-risk pregnancy is associated with both maternal and fetal complications. This study aims at analysing the fetal and maternal outcome in such cases. All cases were studied according to their parity, maternal age, fetal presentation, mode of delivery and gestational age.Methods: This prospective study was conducted at one of the tertiary care teaching institutes over a period of one year from January 2018 to December 2018. Out of a total number of 7295 deliveries, 130 were twin pregnancy. It included all women admitted in labour room with clinical or ultrasound diagnosis of twin pregnancy after 20 weeks of gestation.Results: In the present study incidence of twin pregnancy was 1.78%. We observed the highest incidence of twins in the age group of 20-29 years. The least incidence was below the age of 20 years. Incidence of twin pregnancy in our study in primipara was 47.7% and in multipara was 52.3%. Most of the patients (43%) delivered at 32-36 weeks of gestation. Maternal complications were noticed as anemia in 29.2% patients, pregnancy induced hypertension in 55.4% patients, post-partum hemorrhage in 4.6% patients, polyhydramnios in 3.1% patients, premature rupture of membranes in 8.5% patients, gestational diabetes in 0.8% patients and urinary tract infection in 2.3% patients. Majority of the patients delivered vaginally (60.8%), others by lower segment cesarean section (LSCS). In this study 95.8% babies were low birth weight. There were 34 neonatal deaths (13%).Conclusions: Twin pregnancy is a high-risk pregnancy associated with significantly increased maternal morbidity, neonatal morbidity and mortality. Such pregnancies require good antenatal care, early detection of maternal and fetal complications and timely referral to a centre well equipped for management of such cases. 

scholarly journals Study on prevalence of prelabour rupture of membranes and its maternal and fetal outcomes

2021 ◽  
Vol 10 (11) ◽  
pp. 4163
Author(s):  
Mamatha Poondru ◽  
R. Kala ◽  
A. Kumar
Keyword(s):  
Risk Factors ◽  
Tamil Nadu ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Previous History ◽  
Active Management ◽  
Normal Vaginal Delivery ◽  
Maternal Complications ◽  
Cross Sectional ◽  
History Of

Background: The aim is to study the prevalence of prelabour rupture of the membranes (PROM), to identify risk factors, mode of delivery, and its maternal and fetal effects.Methods: This was a cross-sectional study conducted in the department of obstetrics and gynaecology at Government Head Quarters Hospital, Cuddalore, Tamil Nadu, with a duration of 6months (January 2020 – June 2020). The study was conducted on 800 pregnant women between 28-42 weeks of gestational age consecutively and those who met the inclusion and exclusion criteria were taken into study.Results: The prevalence of PROM was 27.9% (tPROM 24.6% and PPROM 3.2%). Most of the cases were primigravida (74%). Risk factors associated with PROM were low socioeconomic state (63.2%), urinary tract infection (UTI) (7.2%), vaginal infections (5.8%), and previous history of PROM (3.1%). Most of the patients were delivered by lower segment caesarean section (LSCS) (55.2%), normal vaginal delivery (39.9%) and forceps delivery (4.9%). The most common indication for LSCS was fetal distress (43.9%). Misoprostol induction was associated with more failed induction (2 times) than syntocinon. Maternal complications were post-partum haemorrhage (PPH) (8%), fever (6.7%), wound infection (6.2%), manual removal of placenta (4.4%), and puerperal sepsis (0.9%). Neonatal complications were neonatal intensive care unit (NICU) admissions (14%), respiratory distress syndrome (RDS) (11%), neonatal sepsis (2.6%). Maternal (54.5%) and neonatal (90%) morbidity were more in prolonged PROM >24 hours.Conclusions: Antenatal screening for genitourinary infections especially in cases of the previous history of abortions and PROM should be done. Oxytocin is the preferred method of induction over misoprostol in this study. Active management in term PROM cases can reduce the cesarean section rate.

scholarly journals Perinatal Outcome of the Second Twin

2015 ◽  
Vol 10 (1) ◽  
pp. 89-93
Author(s):  
R Joshi ◽  
G Baral
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Admission Rate ◽  
Second Twin

Aims: The purpose of this study was to determine the perinatal outcome of the second twin compared to the first one. Methods: This is a hospital based comparative study of 60 pregnant women with twin pregnancy at Paropakar Maternity and Women’s Hospital, Kathmandu from 14 January 2013 to13 April 2013. Apgar score and admission to neonatal intensive care unit of the first and the second twins were studied in relation to the gestational age, chorionicity, mode of delivery, inter-delivery interval and birth weight. Mc Nemars test was used with 0.05 as the level of significance. Results: Among 60 sets of twins, Apgar score of the second twin was found to be lower than the first one (p=0.02) in general and in preterm gestation (p=0.049), dichorionic diamniotic chorionicity (p=0.012), vaginal delivery (p<0.001), inter-delivery interval of <30 minutes (p=0.007) and birth weight discordance of <30 % (p=0.014). Admission to neonatal intensive care unit was not significant (p=0.5). Conclusions: Second twin had low Apgar score and the neonatal admission rate was similar for both twins. 

CLINICAL AND SUBCLINICAL CHARACTERICTIS AND PREGNANCY OUTCOME OF FETAL MACROSOMIA AT OBSTETRIC DEPARTMENT AT HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2020 ◽  
pp. 78-84
Author(s):  
Giang Truong Thi Linh ◽  
Quang Mai Van
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Vaginal Birth ◽  
Fetal Macrosomia ◽  
Major Influence ◽  
Maternal Complications ◽  
Perineal Tear ◽  
History Of

Background: Fetal macrosomia has a major influence on maternal, neonatal and pregnancy outcomes.Objective: To describe the clinical and subclinical features and the management of fetal macrosomia on pregnancy outcomes. Subjects and methods: Study subjects including pregnant women and babies born ≥ 3500 g with nulliparous and over 4000 grams with primiparous or multiparous at Departement of Obstetrics and Gynecology in Hue University of Medicine and Pharmacy Hospital. The time of choosing subjects to enter the research group is that after birth, the weight is above 3500/4000 grams, then follow up the pregnancy result and retrospect the clinical and subclinical characteristics. Results: From May 2019 to April 2020, there were 223 pregnant women with the birth weight ≥ 3500 g in this study. The mean neonatal weight for macrosomia was 3869.96 ± 315.72 (g). The birth weight ≥ 4000 g, the rate of cesarean section was 91.5%, vaginal birth was 8.5%. The birth weight 3500 - under 4000 g, the rate of cesarean section was 76%, vaginal birth was 24%. 1.1% maternal complications was perineal tear. Conclusion:Factors related to fetal macrosomia: Maternal age, gender of fetus, parity, a history of fetal macrosomia, maternal height, pregnancy weight gain. Caesarean section is the majority. Key words: Fetal macrosomia, gestational diabetes mellitus, normal labor, caesarean section.

scholarly journals Factors Influencing Maternal Mortality from Severe Preeclampsia and Eclampsia

2016 ◽  
Author(s):  
Denny Khusen
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Gestational Age ◽  
Post Partum ◽  
Severe Preeclampsia ◽  
Maternal Complications ◽  
History Of ◽  
Post Partum Bleeding

Objective: To analyze risk factor, both clinical and laboratory findings, associated with maternal mortality from severe preeclampsia and eclampsia in Atma Jaya Hospital. Methods: This was a retrospective case control study. All medical records of maternal death associated with severe preeclampsia and eclampsia between 1st January 2009 and 31st December 2011 were obtained and then information about risk factors were collected and tabulated. Risk factor analyzed were maternal age, gestational age, parity, coexisting medical illness (hypertension), antenatal examination status, maternal complications, systolic and diastolic blood pressure at admission, and admission laboratory data. Results: There were 19 maternal deaths associated with severe preeclampsia and eclampsia during period of study (Consisted of 6 cases of eclampsia and 13 cases of severe preeclampsia). Maternal mortality rate for severe preeclampsia and eclampsia were 16.7% and 33.3% respectively. Multivariate analysis identified the following risk factors associated with maternal death: gestation age <32 week, history of hypertension, thrombocyte count < 100.0000/μl, post partum bleeding, acute pulmonary edema, HELLP syndrome, and sepsis. Conclusion: In this study, we found that gestational age, history of hypertension, and platelet count are the cause of maternal mortality. Maternal complications associated with maternal mortality are post partum bleeding, acute pulmonary edema, HELLP syndrome, and sepsis. [Indones J Obstet Gynecol 2012; 36-2: 90-4] Keywords: eclampsia, maternal mortality, preeclampsia

OUTCOME OF SECOND BABY OF TWIN IN A RURAL TEACHING HOSPITAL OF WEST BENGAL, INDIA

2021 ◽  
pp. 4-7
Author(s):  
Kajal Kumar Patra ◽  
Anirban Mandal ◽  
Thyadi Himabindu
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Perinatal Outcome ◽  
West Bengal ◽  
Mode Of Delivery ◽  
Reproductive Technologies ◽  
Time Interval ◽  
Age Group ◽  
Multiple Pregnancies ◽  
Second Twin

Background: Multiple pregnancies are a high-risk situation because of its inherent risks to mother and the fetus. Twin or multiple pregnancies are gaining importance worldwide because of the attributable rise in treatment of infertility including assisted reproductive technologies. Twin pregnancies are associated with increased fetal loss, prematurity, structural abnormalities, and fetal growth restriction. Complications associated with twin pregnancy. The conduct of a twin delivery remains one of the most challenging events in the current obstetric practice. This Methods: study was an Hospital-based cross-sectional descriptive study conducted in the Department of Obstetrics & Gynaecology of Bankura Sammilani Medical College and Hospital, Bankura, West Bengal from January 2020 to December 2020. 238 patients were included in the study after informed consent from the patient about being a part of this study. Template was generated in MS excel sheet and analysis was done on SPSS software. Results: Majority 154 (64.7%) of women belonged to age group 21-30 years. Gestational age of 159 (66.8%) mothers were < 37 weeks. Perinatal outcome of second twin was highest in the maternal age group 20 years. Perinatal outcome of second twin was highest in the birth weight of the 2nd twin < 2500 grams. Delivery time interval between the babies was maximum 175 (73.5%) is < 10 minutes. Gestational age, Conclusions: presentation, mode of delivery, and birth weight are the signicant determinants of perinatal outcome of the second twin. The second twin is at higher risk of perinatal morbidity and mortality than the rst twin. Frequent antenatal care should be advised to the mothers.

"Neonatal Hepatitis" in Twin Pregnancy

PEDIATRICS ◽  
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.

scholarly journals Epidemiological, clinical, prognostic and therapeutic aspects of twin delivery in two referral maternity units in Dakar (Senegal)

2018 ◽  
Vol 7 (2) ◽  
pp. 364
Author(s):  
Omar Gassama ◽  
Magatte Mbaye ◽  
Aminata Niass ◽  
Diodio Boye ◽  
Babacar Biaye ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Twin Pregnancy ◽  
Placenta Previa ◽  
Uterine Cavity ◽  
Breech Presentation ◽  
Premature Delivery ◽  
Time Interval ◽  
Maternal Complications ◽  
Twin Delivery ◽  
Second Twin

Background: Twin pregnancy is the simultaneous development of two embryos and then two fetuses in the uterine cavity. Objective of present study was to assess the epidemiological, clinical, prognostic and therapeutic aspects of twin delivery in two referral maternity units in Dakar.Methods: A descriptive and analytical retrospective bi-centric study of all cases of twin deliveries recorded in two referral center in Dakar was conducted during the period January 1st, 2005-December 31st, 2015, i.e. an 11-year period. It concerned 619 pregnant women who gave birth to twins in these two referral medical structures. The epidemiological parameters, clinical, prognostic and therapeutic aspects of twin childbirth were studied. The data were entered and analysed using Epi info version 3.5.3.Results: The twinning prevalence was 1.11%. The majority of our parturient women (506 or 81.7% of the cases) came from the Dakar suburbs. The average age of the parturient women was 28 years and the gestity age 3.1. Pregnancy was well monitored for 98.5% of the parturient women with an average number of prenatal consultations of 3.6. The first prenatal consultation was performed in 52% of cases in the first quarter. In more than one third of cases (234 or 37.8%), the diagnosis was made in the third quarter of pregnancy. 113 cases (18.2%) of premature rupture of membranes, 10 cases (1.61%) of threat of premature delivery and 7 cases (11.13%) of placenta previa were registered. During labour, the diagnosis was made by clinical examination in 32.2% of cases. Bichorial biamniotic twin pregnancy was the most frequent anatomical type (62.6%). On admission, the first twin (T1) was in cephalic presentation in 56.7%, in breech presentation in 15.2%; The second twin (T2) was in breech presentation in 21.1% of the cases. Caesarean section was related to the first twin in 50.6% and the second twin in 53.8% of the cases. Caesarean section was performed in 50.6% for the first twin and in 53.8% for the second twin. The mean time interval between the delivery of T1 and that of T2 was 17.4 min. Low birth weight was more frequent for the second twin (54.3%). The stillbirth rate was 48.26 per thousand. Maternal complications were dominated by renal-vascular syndromes (4.2%), haemorrhagic causes (1.86%), perineal lesions (1.6%) and uterine rupture (0.97%). Postpartum haemorrhage was observed in 8 cases (1.29%). Maternal mortality was nilConclusions: Twin delivery poses varying difficulties due to the complexity of obstetrical mechanics and the frequency of dystocic presentations. Despite improved maternal prognosis, in recent years, perinatal mortality and morbidity, still high, remain a constant concern.

scholarly journals Perinatal Outcome Associated with Meconium Stained Amniotic Fluid In Pregnancy

2015 ◽  
Vol 4 (2) ◽  
pp. 44-49 ◽  
Author(s):  
Nasrin Begum ◽  
Sharmeen Mahmood ◽  
Salma Akhter Munmun ◽  
MS Haque ◽  
KN Nahar ◽  
...  
Keyword(s):  
Birth Weight ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Perinatal Death ◽  
Mode Of Delivery ◽  
Neonatal Resuscitation ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Meconium Stained Amniotic Fluid

Objectives: To evaluate perinatal outcome associated with meconium stained amniotic fluid in pregnant women.Methods: It was a prospective cross sectional study, conducted in the Department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2013 to December 2013. Total 50 pregnant women admitted in the labour ward for delivery with meconium stained amniotic fluid were the study population. Singleton pregnancy of more than 34 weeks duration was included and pregnancy with APH, breech presentation, congenital malformation of fetus, IUD were excluded from the study. Out of 50 patients two did not provide all the information needed to analyze the data and hence were excluded. Outcome Variables were gestational age, antenatal checkup, medical diseases of mother (HTN, Diabetes mellitus, Heart disease), obstetric complication (oligohydramnios, prolonged labour), mode of delivery, neonatal details (weight of the baby in kg, APGAR scoring at 1 min & 5 min), neonatal resuscitation, admission in neonatal ICU(NICU), neonatal complications (RDS, MAS, Neonatal death).Results: Over half (52.1%) of the neonates needed resuscitation and 54.2% admitted in ICU. About 90% of the neonates had normal birth weight and only 10.4% were of low birth weight. 14.6% of the neonates developed meconium aspiration syndrome and 10.4% respiratory distress syndrome. Neonatal jaundice and neonatal sepsis were observed in 4.2% neonates each. Four neonates (8.3%) died early in the neonatal life, while 1 (2.1 %) was still-born. Low APGAR score (<7) at 1 and 5 minutes of birth was found in 64.7% and 52.9% of the cases respectively with thick meconium stained amniotic fluid as opposed to 25.8% and 16.1% of the cases respectively having thin meconium stained amniotic fluid (p = 0.008 and p = 0.007 respectively). Thick meconium was significantly associated with meconium aspiration syndrome (p = 0.003). Neonates needing immediate resuscitation and admission in ICU was staggeringly higher in the former group than those in the later group (p = 0.002). The incidence of perinatal death was significantly higher in patients with thick meconium stained amniotic fluid than that in patients with thin meconium ( p= 0.021).Conclusion: Meconium stained amniotic fluid was associated with low APGAR score, higher incidence of MAS, ICU admission and perinatal death.J. Paediatr. Surg. Bangladesh 4(2): 44-49, 2013 (July)

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