MATERNAL MORBIDITY AND PERINATAL OUT COME IN MULTIPLE PREGNENCY

Dr. Aseem Sharma, Dr. Durga B. C.

Abstract


INTRODUCTION

 MULTIPLE PREGNENCIES ARE CONSIDERED AS HIGH RISK PREGNENCIES OVERALL THE RATE OF MULTIPLE PREGNENCIES ARE INCRESING DUE TO OVULATION INDUCTION DRUGS  LIKE CLOMIPHENE CITRATE AND LETRAZOLE.MORE SO EVER DUE TO ASSISTED REPRODUCTIVE TACHNIQUES.THIS IS A UNIVERSAL FACT THAT MULTIPLE  PREGNENCIES ARE ASSOCIATED WITH ADVERSE MATERNAL AND NEONATAL OUT COME AS COMPARED TO SINGELTON PREGNENCY. AMONG THE MULIFETAL GESTATIONS TWINS ARE THE COMMNEST AND SO ON.  

AIMS AND OBJECTIVES

  THE STUDY WAS AIMED TO FIND OUT THE INCIDENCE AND POSSIBLE MATERNAL  AND PERINATAL OUTCOMES OF MULTIPLE PREGNENCIES.

MATERIALS AND METHODS 

 THIS WAS A DESCRIPTIVE AND PROSPECTIVE CONDUCTED IN THE DEPARMENT OF OBS AND GYNE AT NGMC KOHALPUR TEACHING HOSPITAL. A TOTAL OF 50 CASES OF MULTIFETAL PREGNENCY AFTER 28 WEEKS OF GESTATION WAS INCLUDED DURING THE STUDY PERIOD FROM APRIL 2014 TO MAY 2015 WHO FULFILLED THE INCLUSION CRITERIA.   

 DATA COLLECTED WAS BASED UPON CERTAIN CRITERIAS WERE FOLLOWS:-

1  AGE

 2 OBSTETRICS HISTORY

3  NO. OF FETUSES,

4 MODE OF DELIVERY

 5 INDICATION FOR LSCS EITHER ELECTIVE OR EMERGENCY

6 FOETAL OUT COME

7 MATERNAL COMPLICATIONS

EXCLUSION CRITERIA

1 PREGNANT WOMEN WITH PREVIOUS LSCS

2 CEPHALO-PELVIC DISPROPORTION

3 MULTIPLE BIRTH OF THOSE MOTHER WHO ARE NOT WILLING PARTICIPATE.

RESULT.

IN THIS STUDY 50 CASES OF MULTIFETALPREGNENCY WERE ANALYSED. THE HOSPITAL BASED STUDY WAS 2.1 % . AMONG THEM 92% WERE TWINS AND 6 % WERE TRIPLETS, 2% Multiple Pregnancy. the mutiple pregnancies werw common in 32-36 yrs of age group(40%). Mutilpe pregnancies were seen more in mutligravidae(58%). The main matrenal adverse outcomes were preterm labor(64%), followed by anaemia(42%), premature rupture of membrane(40%), PIH(29%), PPH(26%), Perpuralsepsis, APH, GDM. The mean gestattional age in the study was 37 weeks and 35 weeks in twins and triplets. The most common mode of delivery was vaginal(60%) whereas all the triplets were delivered by ceasearn section. The most common indication for LSCS was malpresentation(63%) and the most common fetal presentation was cephalic-cephalic for twins and cephalic-breech-breech for triplets. The most common neonatal complication was prematurity and neonatal sepsis. The overall prenatal motality rate in our study was 26% an perinatal motality was higher in second twin(30%) compared to first twin(20%). No moratality was observed among triplets.

CONCLUSION                           

Multiple Pregnancy have high maternal and neonatal complication mainly preterm delivery that increses the risk of neonatal morbidity and mortality.


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References


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