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Outcome in multifetal pregnancy - A cohort study

Background and Objectives: Twin pregnancies remain a major health problem given the increased incidences of both maternal and foetal complications in the country. This study provides relevant clinical and public health information that will help the clinicians on how to manage multiple pregnancies and prevent complications.
Purpose of the Study: 1. To determine maternal complications in multifetal pregnancy; 2. To determine the foetal and postnatal outcomes in multifetal pregnancy.
Materials and Methods: Research approach and design -A Prospective and Retrospective Cohort study.
Study Setting: Department of Obstetrics and Gynaecology, Amala Institute of Medical Sciences Thrissur, Kerala.
Study Population: All antenatal patients satisfying the inclusion criteria were included in the study.
Results: The incidence of multifetal pregnancy was 1.55% in our institution. Preterm labour complicated 25.6% of multiple pregnancies, 4.3% were complicated by abruptio placentae and 0.9% were complicated by placenta praevia. Gestational hypertension complicated 12% of pregnancies. Majority (55.6%) were delivered by LSCS, whereas 39.2% delivered vaginally and 5.2% had operative vaginal deliveries. Postpartum haemorrhage complicated 17.9% of twin deliveries. The incidence of prematurity among babies of multiple pregnancy was 53%. The total fetal loss was 3.4%. There was no maternal mortality in our study.
Conclusion: Multiple pregnancies had a higher likelihood of adverse maternal and perinatal outcomes than singleton pregnancies. Mothers carrying multifetal pregnancy should be properly counselled regarding all the complications and should be kept under constant monitoring.

Keywords: Fetal outcome, Maternal outcome, Multifetal pregnancy, Singleton pregnancy.