scholarly journals “CLINICAL STUDY OF CLAVIEN-DINDO CLASSIFICATION TO ASSESS THE GRADES OF COMPLICATION AND FACTORS RESPONSIBLE IN CASES OF GASTROINTESTINAL PERFORATIONS IN A TERTIARY CARE CENTRE”

2021 ◽  
pp. 1-10
Author(s):  
Ankur Deshwali ◽  
Rajesh Sharma
Keyword(s):  
Operative Procedure ◽  
Tertiary Care ◽  
P Value ◽  
High Morbidity ◽  
Complication Rates ◽  
Comorbid Conditions ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Perforation Peritonitis

INTRODUCTION Perforation peritonitis is one of the most common surgical emergencies across the globe. Gastrointestinal perforations have very high morbidity and mortality rates, irrespective of the type of operative procedure performed. The Clavien-Dindo system is nowadays widely used for complications after surgery for grading adverse events (i.e. complications) which occur as a result of surgical procedures and has become the standard classification system for many surgical specialties for open as well as laparoscopic surgeries . In this study, an attempt is made to find out various preoperative and intra operative factors that may responsible for adverse outcome and to identify the best management that could decrease the complication rate with special reference to CLAVIEN-DINDO classification. MATERIALS AND METHODS We did an observational study of 60 perforation peritonitis patients admitted in Department of Surgery, Sri Aurobindo Medical College and Post Graduate Institute, Indore, M.P. between November 2017 to May 2019(1 and 1/2 Year) on the basis of Clavien-Dindo classification.All were studied with respect to clinical features, time of presentation, comorbid conditions, investigations, intervention done, operative findings and postoperative course and all the data was entered in preformed proforma RESULTS Total 60 patients of perforation peritonitis admitted and treated in the department, During the period of November 2017 to May 2019. End of the study concludes the following points: • In my study, most of the cases were between age group 20-39(50%). more common in males 41 (68.33%). who presented after 3 days from onset of symptoms 20 (33.33%) all of them had complications 20(100%). P Value was<0.001 which is significant. In 16 (26.6%) patient’s comorbid conditions were present, out of them 12 (75%) patients were haemodynamically unstable and 9(56.25%) patient expired.In 29 (48.33%) patient size of perforation was more than 1 cm out of which complication observed in 28(96.55%) patient.. P Value was <0.001 which is significant. In 10 (16.66%) patients multiple perforations were found out of which 09 (90%) patients were unstable. Complication occurred in 09(90%) patients . In this group 6(60%) patient expired. P Value was 0.001 which is significant . In 24(40%) patients more than 500 ml intraperitoneal collection was found, out of which complications developed in all 24(100%) patients,. Chi Square Value was 42.8 and P Value was<0.001 which is significant. Complication according to clavien -dindo classification 14 out of 60 (23.33%) patients had no complications, 4 (6.66%) had grade I complication, 5 (8.33%) had grade II complications, 12 (20%) had grade III complications, 11 (18.33%) had grade IV complications, and 14 (23.33%) had grade V complication rates . CONCLUSION Post-operative complications increase due to comorbid conditions, size and number of perforations and it also affects the outcome of the patient. It is observed that with the increase in contamination (intraperitoneal collection) morbidity increases.For the classification of complications, a new system is proposed by Clavien–Dindo which is very helpful during perforation surgery, it is used in all over the world and facilitates in comparisons or evaluation of various surgical . The new classification mainly focuses on the medical perspective, with a major emphasis on the risk, type of anaesthesia and procedures or therapy used to correct a complication. We therefore recommend the use of clavien-dindo classification of complications.

scholarly journals AN OBSERVATIONAL STUDY ON ASSESSMENT OF POSTOPERATIVE COMPLICATIONS AMONG PERFORATION PERITONITIS USING CLAVIEN-DINDO CLASSIFICATION IN TERTIARY CARE CENTER OF CENTRAL INDIA

2021 ◽  
Vol 9 (02) ◽  
pp. 922-937
Author(s):  
Ankur Deshwali ◽  
◽  
Sanjay Prasad ◽  
Akhilesh Kumar Patel ◽  
Rohan Chaphekar ◽  
...  
Keyword(s):  
Observational Study ◽  
Abdominal Surgery ◽  
Care Center ◽  
Tertiary Care ◽  
P Value ◽  
Complication Rates ◽  
Medical College ◽  
Sri Aurobindo ◽  
Perforation Peritonitis

Introduction :Surgical team always tries to provide consistently low incidence of major complications for patient undergoing any operation. Clavien-Dindo (CD) classification is the simplest way of reporting all complications. The main aim of this study was to test the usefulness of Clavien-Dindo classification in patients undergoing the abdominal surgery. In this study Clavien-Dindo classification has been used for assessment of postsurgical complications after major abdominal surgery. Material and method: It was an observational study of all perforation peritonitis patients admitted in sri aurobindo medical college and post graduate institute between november 2017 to may 2019 (1 and 1/2 Year) on the basis of Clavien-Dindo classification. Results :This was an observational prospective study was carried out in Department of General Surgery, Sri Aurobindo Medical College and P.G. Institute, Indore, which includes total 60 patients of perforation peritonitis admitted and treated in the department, During the period of November 2017 to May 2019. In our study Most common symptoms in patients presenting with perforation is Abdominal pain in 60 (100%) patients. 45(75%) patients had constipation & obstipation, 41 (68.33%) patients had vomiting ,33(55%) of patients had fever 17 (28.33%) patients had abdominal distensions the other common symptoms. Out of 60 patients, all 60(100%) patients had abdominal tenderness and guarding, 47 (78.33%) patients had absent bowel sounds, 42(70%) patients had tachycardia, 26 (43.33%) patients had hypotension, 23 (38.33%) patients had tachypnoea and 21 (35%) patients had low urinary output. In 16 (26.6%) patients comorbid conditions were present. In 10 (16.66%) patients multiple perforations were found out of which only 01 (10%) patient is haemodynamically stable and 09 (90%) patients were unstable. Complication occurred in 09(90%) patients and no complication were only in 01 (10%) patients. In this group 04(40%) patients got discharged and 6(60%) patient expired. P Value was 0.001 which is significant. In our study most common site of perforation was gastric perforation 30(49.18%) Complication according to clavien -dindo classification 14 out of 60 (23.33%) patients had no complications, 4 (6.66%) had grade I complication, 5 (8.33%) had grade II complications, 12 (20%) had grade III complications, 11 (18.33%) had grade IV complications, and 14 (23.33%) had grade V complication rates. Conclusion :Perforation peritonitis is a life-threatening condition and requires urgent hospital care, resuscitation and surgery. Early resuscitation and surgery are required to decrease morbidity and mortality. On the basis of risk stratification in Peritonitis patients its management requires lots of expensive modalities, skill, monitoring and treatment to provide better care to the patient. For the classification of complications, a new system is proposed by Clavien–Dindo which is very helpful during perforation surgery.Clavien- Dindo classification helps us to distinguish a normal postoperative course and the severity of complications, which allows us to compare postoperative morbidity and evaluate the outcomes. We also recommend a larger study with a bigger sample size for better analysis of clavien-dindo classification of complications and to confirm the findings of our study.

scholarly journals Comparative study of fetomaternal outcome in adolescent and young adult primigravidas

2017 ◽  
Vol 5 (3) ◽  
pp. 912
Author(s):  
Kanti Meherda ◽  
Shikha Mathur
Keyword(s):  
Young Adult ◽  
Adolescent Pregnancy ◽  
Economic Status ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Adolescent And Young Adult ◽  
Control Group ◽  
P Value ◽  
Tertiary Care Centre ◽  
Chi Square

Background: Adolescent pregnancy is a worldwide public health problem. WHO has defined adolescence as the period from 10-19 years of age. Purpose of the study was to compare the fetomaternal outcome in adolescent and young adult primigravidas.Methods: The study was conducted at a tertiary care centre over a period of six months. 150 adolescent (in our study between 15-19 years of age) and 150 young adults (20-25 years) primigravidas who delivered at our institution were randomly selected for the study. All the data including age, booking status, educational and economic status and address were noted. All essential antepartum, intrapartum and postpartum data were collected for both the groups and compared using Chi square test.Results: In our study the incidence of antepartum, intrapartum and postpartum complications was 86%,36% and 10% respectively in the study group. But in the control group only 40% of the subjects had antepartum complications ,17.33% had intrapartum complications and the incidence of postpartum complications was only 4%. The difference is highly significant with a p value <0.001.Conclusions: Adolescent pregnancy is associated with adverse fetomaternal outcome and any effort to prevent it is worthwhile.

scholarly journals Validity of mannheim peritonitis index in predicting outcome of patients with perforative peritonitis in a tertiary care centre Kerala, India

2019 ◽  
Vol 7 (11) ◽  
pp. 4140
Author(s):  
Alex Mathew ◽  
Joby John ◽  
Asha Sasikumar
Keyword(s):  
Likelihood Ratio ◽  
Tertiary Care ◽  
Prognostic Index ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
P Value ◽  
Care Centre ◽  
Roc Curve Analysis ◽  
Tertiary Care Centre ◽  
Perforation Peritonitis

Background: Perforation peritonitis is one of the most commonly encountered surgical emergencies in our country. The prognosis of secondary peritonitis remains poor despite development in diagnosis and management. Early identification of patients with severe peritonitis may help in selecting patients for aggressive surgical approach.Methods: The study was conducted in 128 cases of perforation peritonitis admitted and treated in the department of surgery in a tertiary care centre. Initial diagnosis was made on the basis of detailed history, clinical examination and presence of pneumoperitoneum on erect abdominal X-ray. Patients were first assessed using a predesigned Performa, then MPI score was calculated for each patient and the patients were followed-up till death or discharge from the hospital.Results: The ROC curve analysis shows area under the curve was 0.986 with a standard error of 0.008, 95% CI (0.971 to 1.001), p<0.0001. In our study authors found that for the MPI score of 26, sensitivity was 91.3% and specificity was 92.4%, with a positive likelihood ratio of 12.01 and a negative likelihood ratio of 0.09. Age of the patient, presence of organ failure, associated malignancy, generalised type of peritonitis and the original MPI Score has got a significant association with the final outcome (i.e. p value <0.05).Conclusions: MPI is an excellent prognostic index for peritonitis with high accuracy in individual prognosis that is cheap, cost effective, easily measurable and reproducible. The study accentuates that early diagnosis, appropriate resuscitation and prompt surgical intervention still remain the keystones in the management of perforation peritonitis.

A knowledge, attitude and practice study on awareness of contraception among postpartum women in a tertiary care centre

2021 ◽  
Vol 12 (2) ◽  
pp. 1597-1601
Author(s):  
Sivasundari Maharajan ◽  
Dhanvarsha Sumaldha Subbiah Ramkumar ◽  
Perni Navya Sree
Keyword(s):  
Postpartum Period ◽  
Economic Status ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
P Value ◽  
Postpartum Women ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Factors Affecting ◽  
Practice Methods

Despite being the first country to launch the National Family Planning Programme in 1952, India still lags behind in practising contraception. This study was conducted to assess knowledge, awareness and practice methods of contraception during the postpartum period. The study included 720 postpartum women; details including awareness and practice methods of contraception and factors affecting use by the postpartum women were obtained. Statistical analysis was done by using the chi-square test and percentage (%). The mean age of postpartum women was 26.5 years, 28.19% were literate between 9th - 12th grade, 96.94% women were housewives. Among them, 56% of women were aware of at least one contraception and correct usage. Among them, 98.01% knew about sterilization. About 48.88% of women were aware of more than one method of contraception. After counselling, 97.2% of women were willing to use contraception. However, 2.78% of patients chose abstinence. In our study, knowledge about contraception based on education and socio-economic status of women shows significant association (p-value <0.00001 for both). Health professionals should evaluate the level of awareness, create awareness and provide education regarding methods of contraception for use in the postpartum period to improve maternal and fetal outcome. 

scholarly journals Haematological profile of diabetes and non-diabetes patients in rural tertiary centre

2017 ◽  
Vol 4 (5) ◽  
pp. 1271 ◽  
Author(s):  
Harish Kumar S. ◽  
Srinivasa S. V. ◽  
Prabhakar K.
Keyword(s):  
Tertiary Care ◽  
P Value ◽  
Diabetic Patients ◽  
Equal Proportion ◽  
Tertiary Care Centre ◽  
Type 2 Diabetic Patients ◽  
Chi Square ◽  
Haematological Profile ◽  
Diabetes Patients

Background: Anemia is a common haematological finding in diabetic patients. Many research studies have reported that anemia mostly occurs in patients with diabetes who also have renal insufficiency. A few other studies have also reported an incidence of anemia in diabetics prior to evidence of renal impairment. Anemia occurs earlier and at a greater degree in patients presenting with diabetic nephropathy than those presenting with other causes of renal failure. The objective of this study is to determine the haematological profile among type 2 Diabetes mellitus in comparison with non-diabetic controls.Methods: Hospital based case control study was conducted in a rural tertiary care centre for a period of 1 year (May 2016 to April 2017) among type 2 diabetic patients and equal proportion of controls without diabetes. 70 diabetics and non-diabetics as controlled were enrolled for the study. Pretested and structured questionnaire was used to collect the data from subjects. For laboratory investigation 5 ml of blood was drawn from the patient and analysed in the automated cell counter for haematological parameters. Data was analysed using SPSS 22 version, Chi-square test and independent t test was the test of significance for qualitative and quantitative data respectively. P value of <0.05 was considered to be statistically significant.Results: Mean age of diabetics was 55.7±3.6 years and non-diabetics was 56.2±3.5 years. Majority of subjects in both the groups were females. In diabetics mean haemoglobin, RBCs, PCV, and MCV was significantly lower than in non-diabetics. Whereas mean MCHC, WBCs and lymphocytes was significantly higher in diabetics compared to non-diabetics. No difference was observed for MCH, neutrophils and platelets between two groups. This shows that diabetics are prone for anemia, leucocytosis and lymphocytosis.Conclusions: Haematological profile in diabetes patients in deranged and diabetics are more prone for anemia, leucocytosis and lymphocytosis. Hence routine and regular screening for haematological profile is recommended in diabetic patients to initiate early prevention strategies and to reduce the morbidity related to it.

scholarly journals Study of expression of PTEN and Cyclin D1 in endometrium at a tertiary care centre

2019 ◽  
Vol 6 (2) ◽  
pp. 495
Author(s):  
Shaffy Thukral ◽  
Shuaeb Bhat ◽  
Nusrat Bashir
Keyword(s):  
Cyclin D1 ◽  
Tertiary Care ◽  
Inverse Correlation ◽  
Premalignant Lesions ◽  
P Value ◽  
Nuclear Staining ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Normal Endometrium ◽  
Chi Square Test

Background: To study the expression of PTEN (Phosphatase and Tensin homologue) and Cyclin D1 in normal, hyperplastic and neoplastic endometrium by immunohistochemistry and to corroborate the interrelationship between PTEN and Cyclin D1 in normal to neoplastic endometrial disorders including endometrial carcinoma.Methods: Formalin fixed paraffin embedded (FFPE) sections of spectrum of endometrium in fifty different cases were taken from secretory phase to endometrial carcinoma and subjected to Immunohistochemistry using PTEN and Cyclin D1 .Results: Immunoreactivity was regarded as positive when brown staining was localized in the nuclei or cytoplasm. The intensity of nuclear staining was graded from 0 to 3+ and the extent was semi quantitatively estimated. If less than 10% of cells were positive a score of 0 was given, 11 % to 30% cell positivity was scored as 1+, 31% to 60 % positivity was scored as 2+ and more than 60% positive cells was labelled as 3+. Statistical analysis was performed with Chi-Square test and significant differences were noted between these 3 groups (p value < 0.05).Conclusions: The present study supports that an inverse correlation exists in the expression of PTEN and Cyclin D1 in normal, hyperplastic and neoplastic endometrium. The decreased PTEN expression is a marker of the earliest endometrial premalignant lesions, and we propose that use of PTEN immunostaining may be informative in identifying premalignant lesions that are likely to progress to carcinoma. Cyclin D1 expression in endometrial glands increases progressively in intensity and extent from normal endometrium to hyperplasia to carcinoma.

scholarly journals A study of haematological profile of malaria in a tertiary care centre of western Uttar Pradesh, India

2018 ◽  
Vol 5 (3) ◽  
pp. 1115 ◽  
Author(s):  
P. L. Prasad ◽  
Preeti Lata Rai ◽  
Mohd. Shoaib Hussain
Keyword(s):  
Wide Spectrum ◽  
Tertiary Care ◽  
Hypochromic Anemia ◽  
Plasmodium Falciparum Malaria ◽  
P Value ◽  
High Morbidity ◽  
Monocyte Count ◽  
Tertiary Care Centre ◽  
Major Health Problem ◽  
Haematological Profile

Background: Malaria is a major health problem in tropics with a high morbidity and mortality. Malaria causes wide spectrum of manifestation both clinical as well as hematological. A variety of haematological alterations like progressively increasing anaemia, thrombocytopenia, leucocytosis or leukopenia and rarely disseminated intravascular coagulopathy (DIC) have been reported in malaria. Though clinical manifestation has been widely studied but there is paucity of work in hematological abnormality.Methods: The hospital based observational study was conducted in the Department of Paediatrics, Shri Rammurti Smarak Insitute of Medical Sciences (SRMSIMS), Bareilly. Ninety-eight cases were positive for malaria by peripheral smear or by rapid diagnostic test for malaria or by both.Results: In the present study, prevalence of malaria found to be (11.6 %). Out of 98 cases, 60 were males, majority of cases belonged to 9-12 years of age, followed by 4-8 years of age. Male:Female ratio is 1.57:1. There was neutrophilic predominance and low monocyte count in cases positive for plasmodium falciparum malaria. All the patients had microcytic hypochromic anemia as per mean of MCV. In haematological profiles of malaria neutrophil and monocyte showed statistically significant variations (P value ≤0.001)Conclusions: Anemia is the most common hematological abnormality. There was neutrophilic predominance and low monocyte count in cases positive for malaria which is highly significant. All the patients had microcytic hypochromic anemia as per mean of MCV. Profound thrombocytopenia is very common in malaria.

Comparison of Clinical Outcomes With Drug Coated Balloons Versus Plain Balloon Angioplasty In Chronic Limb-Threatening Ischemia

2021 ◽  
pp. 153857442110225
Author(s):  
Joel Mathew John ◽  
Vimalin Samuel ◽  
Dheepak Selvaraj ◽  
Prabhu Premkumar ◽  
Albert A Kota ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Interventional Procedure ◽  
Tertiary Care ◽  
Arterial Disease ◽  
Multivariable Logistic Regression Analysis ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Exact Test ◽  
Institutional Review ◽  
Chi Square Test

Objective: The use of drug coated balloon (DCB) for angioplasty has shown superior efficacy against plain balloons for treating complex infrainguinal arterial disease. We report and compare the clinical outcomes following application of DCB(Paclitaxel) and plain angioplasty (POBA) in our tertiary care centre. Methods: A retrospective, single centre analysis of 301 patients with chronic limb-threatening ischemia involving the infrainguinal segment was conducted between September 2014 and September 2018, after approval from the Institutional review board. We analyzed clinical outcomes by measuring postoperative ABI improvement, restenosis requiring reintervention procedure, minor and major amputations at the end of 18 months. . To find the association between the group variables (POBA and DCB) and other risk variables, Chi-square test/Fisher’s exact test was used. Multivariable logistic regression analysis was used. Results: Patients who underwent treatment with plain balloon (POBA) and DCB(Paclitaxel) angioplasty were 246(81.7%) and 55(18.3%) respectively. Our study group was predominantly male (Male: Female = 6.7:1), most patients were more than 50 years of age (n = 251, 83.4%). Smoking (n = 199, 66.1%) and diabetes (n = 210, 69.8%) were the most common atherosclerotic risk factors. Postoperative Ankle Brachial Pressure Index (ABI) improvement were similar in both groups (POBA = 57.7%; DCB = 69.8%; p = 0.103). Minor and major amputations following POBA were 26% and 22%; and DCB were 12.7% and 16.4% respectively. Re-stenosis requiring a re-interventional procedure within 18 months was 15%, (n = 37) following POBA; and 12.7% (n = 7) following DCB (p = 0.661). Conclusions: This retrospective study shows similar clinical limb related outcomes following POBA and DCB at 18 months. However, our comparative analysis between the POBA and DCB groups was totally unadjusted and not adjusted for common confounders such as age and sex. Hence, for one to draw definitive conclusions leading to changes in clinical practice; a randomized, prospective study with a larger patient cohort is needed.

SPECTRUM OF HISTOPATHOLOGICAL LESIONS OF FEMALE GENITAL TRACT - STUDY IN A TERTIARY CARE CENTRE

2021 ◽  
pp. 19-21
Author(s):  
Naik Viraj R ◽  
Manjusha Jindal ◽  
Siddhi D. Naik
Keyword(s):  
Genital Tract ◽  
Malignant Tumors ◽  
Benign Lesion ◽  
Tertiary Care ◽  
Female Genital Tract ◽  
Screening Methods ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Histopathological Lesions ◽  
Female Genital

Introduction: (1) The female genital tract is constituted by the ovaries, fallopian tubes, uterus (body/corpus and cervix), vagina, and vulva. Female genital tract lesions can be benign or malignant. Our study was carried out to nd out the frequency of various histopathological lesions including neoplasms of female genital tract. Materials and Methods: Our study is retrospective conducted over 2 years period. Data was collected from case records of patients presenting to Goa Medical College and histopathology reports obtained from Dept of pathology. Data was represented in form of charts and tables. The analysis of statistical data of variables was done using SPSS software version 22. Signicance was calculated using chi square test. Value of p <0.05 was considered signicant. Results: Out of total 270 subjects studied, 229 were having benign lesions and 41 had malignant lesions.The mean age was 49.5 years. Leiomyoma was diagnosed in (40.58%) cases. In abnormalities of endometrium proliferative endometrium was seen in 37.6%. Chronic cervicitis was seen 78.74% cases. Among the ovarian lesions, 67.74% cases were simple follicular cysts. Cervical cancer was found in 73.17% cases followed by ovarian malignancies in 19.51 % cases, endometrial carcinoma in 4.87% cases and vulvar cancer in 2.44% cases. Among the malignant tumors (58.54%) cases were postmenopausal women. Conclusion: Microscopic assessment and clinico-pathological correlation of lesions is necessary as grossly identiable benign lesion may harbour a focus of malignancy. It aids to appropriate management in the postoperative period. A concerted effort should be done towards prevention of cancers, by creating awareness through health education in addition to implementation of screening methods.

scholarly journals Comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy at tertiary care centre

2017 ◽  
Vol 6 (6) ◽  
pp. 2395
Author(s):  
Divya Gupta ◽  
Premlata Mital ◽  
Bhanwar Singh Meena ◽  
Devendra Benwal ◽  
. Saumya ◽  
...  
Keyword(s):  
Twin Pregnancy ◽  
Tertiary Care ◽  
Comparative Assessment ◽  
P Value ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Singleton Pregnancy ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Twin Pregnancies

Background: Multiple pregnancy remains one of the highest risk situations for the mother, foetus and neonate despite recent advances in obstetrics, perinatal and neonatal care. Twin pregnancies have increased rates of obstetric and perinatal complications compared to singletons Objective of present study was comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy in Obstetrics and Gynaecology Department of S.M.S. Medical College, Jaipur.Methods: This was a hospital based, prospective observational study done in the Department of Obstetrics and Gynaecology. S.M.S. Medical College, Jaipur from April 2015 to March 2016. 150 women with twin pregnancy and 150 women with singleton pregnancies at gestation age of 28 weeks and above coming for delivery and consented for the study were included in the study. Women with chronic medical disorder or chronic hypertension were excluded from the study. Maternal and neonatal outcome recorded and analysed.Results: Occurrence of twin in our study was 2.82%. Risk of preterm labour was about nine times higher in twin pregnancies than the singleton (OR: 2.74, 95% CI; 1.4494-5.1884, P value 0.001). The risk of premature rupture of membrane was increased by 2.74 times in twin pregnancies (OR:2.74; 95% CI: 1.4494-5.1884, p value .001). There was 3-time increased risk of malpresentation (OR 3.14; CI:1.7184-5.7480, p value .00002) and 2.28 times increase in hypertensive disorder (OR 2.28; 95% CI: 1.0727-4.8823, p value .03) in twin pregnancies. The risk of asphyxia and septicaemia was 2.5 times more in twins.Conclusions: Twin pregnancy is a high-risk pregnancy with more complications in mother and foetus and is a great challenge for obstetrician. So, it should be managed carefully at tertiary care centre to reduce the maternal and perinatal mortality and morbidity.

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