Fetomaternal Outcome of Patients with Multiple Pregnancy: A Single Centre Experience

Dr. Salma Akhter, Mohibul Islam, Latifa Zaman, Sk Tasnuva Alam, Ferdous Ara Banu
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Abstract

Background: Multiple pregnancies are prone to be associated with adverse maternal and perinatal outcome. The incidence of multiple pregnancies has shown a significant increase over the last decades. Aim of the Study: This study aimed to describe the maternal and perinatal outcomes in multiple pregnancies delivered in a tertiary care hospital, Bangladesh. Methods: This was a prospective observational study; 23 patients were enrolled and analyzed. The study conducted with 23 women with twin pregnancies, over 2 year’s months from January 2020 December 2021 in the department of Gynecology and Obstetrics, Chittagong Medical College and Hospital, Chittagong, Bangladesh. Result: Out of 23 cases, 8 patients had intrapartum complications like PPH, mal-presentation, cord prolapse, low-lying placenta, and placental abruption. In this, 4(23.53%) had mal-presentation, and only one had PPH. These intrapartum complications were also categorized according to their chronicity. Mal presentations were seen in 23.53% of DCDA and 33.3% of MCDA with p=0.47. Both were not statistically significant, as shown in Table 4. These twin-specific complications were noted according to their chronicity. Discordant twin was seen in 11.76% of DCDA and 16.67% MCDA. Single IUD in 7.9% of DCDA. The complications and outcomes of the study population; more than 65% of patients needed NICU. In our study, we noted 4 perinatal death caused by intrauterine death, twin-to-twin transfusion syndrome, birth asphyxia, and respiratory distress. Conclusion: Majority of the multiple pregnancy is high risk one. So, all multiple pregnancies need early diagnosis, adequate antenatal, intra-natal and post-partum care to improve the outcome and should have mandatory hospital delivery.
多胎妊娠患者的胎儿结局:单一中心经验
背景:多胎妊娠容易与不良的孕产妇和围产期结局相关。在过去的几十年里,多胎妊娠的发生率显著增加。研究目的:本研究旨在描述在孟加拉国一家三级护理医院分娩的多胎妊娠的孕产妇和围产期结局。方法:前瞻性观察性研究;23例患者入组并进行分析。该研究于2020年1月至2021年12月在孟加拉国吉大港医学院和医院妇产科对23名双胎妊娠妇女进行了为期2个多月的研究。结果:23例患者中,8例出现PPH、畸形呈现、脐带脱垂、胎盘低垂、胎盘早剥等产时并发症。其中4例(23.53%)有不良表现,仅有1例有PPH。这些产时并发症也根据其慢性程度进行分类。恶性表现在23.53%的DCDA和33.3%的MCDA中出现,p=0.47。两者无统计学意义,如表4所示。根据其慢性程度记录这些双特异性并发症。不一致性双胞胎在DCDA和MCDA中分别占11.76%和16.67%。单宫内节育器占7.9%。研究人群的并发症和结局;超过65%的患者需要重症监护病房。在我们的研究中,我们注意到4例由宫内死亡、双胎输血综合征、出生窒息和呼吸窘迫引起的围产期死亡。结论:多胎妊娠以高危妊娠为主。因此,所有多胎妊娠都需要早期诊断,充分的产前、分娩和产后护理,以改善结果,并应强制住院分娩。
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