Epidemiology and perinatal outcomes of multiple gestation pregnancies in a tertiary care centre in the Himalayan region of India

Background: Multiple gestation pregnancy is considered a high-risk pregnancy due to increased maternal and perinatal morbidity as compared to singleton pregnancy. Their management becomes even more challenging in hilly areas due to difficult terrain and frequent natural disasters. Objective of this study is to identify risk factors and feto-maternal outcomes of twins/triplets in Himalayan region. Material and Methods: Hospital based retrospective study which included all twin/triplet deliveries done in the hospital with period of gestation >24 weeks. Maternal and foetal outcome were studied. Results: Multiple-gestation delivery rate was 1.29%. Most women were aged 20–29 years. The mean period of gestation (POG) at delivery was 34.97 ± 3.64 weeks. 59.0% were dizygotic and 41% were monozygotic. LSCS rate was 47.5% with malpresentation being most common indication. Spontaneous pre term labour was most common maternal complication followed by PPH. Developmental delay was recorded on follow up of pre term babies in 33.3% cases. Conclusion: Twin pregnancy is a high-risk pregnancy associated with increased maternal and foetal morbidity. Management of such cases become more difficult in resource limited and geographically difficult areas. Early identification of high-risk factors and timely referral to an equipped centre are essential for better maternal and foetal outcomes.

Keywords: Twin/ triplet pregnancy, pre term labour, malpresentation.