Retrospective analysis of Twin pregnancies -Types of placentation and its association with perinatal outcome

Abstract

Background: Twin pregnancies are associated with significantly higher morbidity and mortality than are singleton pregnancies. Twin gestation, a high-risk pregnancy is responsible for 10% of all perinatal mortalities. In addition, there is significant morbidity in terms of discordant growth, premature deliveries, and requirement of neonatal intensive care. The diagnosis of chorionicity is important because the adverse perinatal outcome depends upon the chorionicity. Monochorionic twins are at higher risk than dichorionic twins for perinatal mortality and morbidity Also, chorionicity may be determined antenatally and used for the clinical management of the fetus and early fetal surveillance.Aims and objectives: 1. To study the perinatal outcome in twin pregnancies and its association with demographic factors. 2. To analyze and compare perinatal outcome in twin Monochorionic and dichorionic pregnancy.Material and Methods: The study was retrospective, observational study conducted in Tertiary Care Hospital in Mumbai in 2018. The hospital records of the twin pregnancies delivered were studied. The sample size was 50 (N=50) and it included both Monochorionic and dichorionic pregnancies. The patients with maternal co-morbidities like DM or other systemic illness were excluded from the study. The patients were divided into two groups, depending upon the chorionicity that is Monochorionic or dichorionic twins. The demographic and epidemiological factors like age, parity, etc. were studied. The perinatal outcome was then analysed in terms of type of delivery, gestational age at delivery birth weight and condition at discharge.Statistical analysis: Data was entered in Microsoft Excel and analyzed. The descriptive statistic were used to compare the various outcomes in Monochorionic and dichorionic twin pregnancy. Chi square test, student t test were used to compare difference in both groups. A p value >0.05 was considered as statistically significant. Conclusion and Recommendations: The perinatal mortality and morbidity is high in Monochorionic pregnancy as compared to dichorionic pregnancy in twin deliveries. The knowledge of monochorionicity and dichorionicity in early pregnancy may be helpful to know the type of placentatation and the subsequent perinatal outcome.