Neonatal Outcome of Twin Pregnancy In Al-Yarmouk Teaching Hospital

K. Al-Jboury, Sundus; Abdul Jabbar Abdullah, Aysar; Jassim Al-izzi, Fadia; Nabeel Kamal, Dina

	Neonatal Outcome of Twin Pregnancy In Al-Yarmouk Teaching Hospital
IRAQI JOURNALOF COMMUNITY MEDICINE
Article 1, Volume 28, Issue 4, 2015, Pages 184-189
Authors
Sundus K. Al-Jboury; Aysar Abdul Jabbar Abdullah; Fadia Jassim Al-izzi; Dina Nabeel Kamal
Abstract
Background: -If twin pregnancy has not risen in our country yet, it will do so sooner, largely due to the extended use of assisted reproductive technologies. International data points that approximately 50% of twin pregnancies deliver preterm, and major complications associated with prematurity. These complications drive the perinatal mortality rate of twins to seven times thatof singletons. Optimizing the route of deliveryfor twins is an important component of care that must be thoughtfully considered. Objective: - To assess the current outcome of twin pregnancy in Al Yarmouk Teaching Hospital, with special emphasis on the determinants of the outcome of the twins born second. Methods:-prospective analysis of every twin delivery had born in the period from Aug. 2010 till the end of Aug. 2011. Review of the antenatal care card, or review the antenatal period with patients if the card not available. Recording the plan of delivery, and the intradelivery events. The primary outcome was a composite measure of neonatal mortality and morbidity, including birth asphyxia, respiratory distress, neonataltrauma, and infection. Logistic regression models were used to study the potential confounders. Risk of adverse outcome of the second twins relative to the first-born-co-twins was determined by matched-pair analysis. Results: - during this period, there was 15035 deliveries, with 260 twin pairs (1.73%). The mode of delivery was a planed vaginal delivery in 57 twin pairs, elective caesarian section in 171, and emergency section in 30 patients, in two cases the initial vaginal delivery ended in section for the second twin. The first twins had less morbidity and mortality than the corresponding second twins, 64 vs 73 for morbidity, and 13 vs. 17 mortality. The total percentage of death was 10.4% among twin pregnancy. The birth weight discordance and planned caesarian section at term had positive correlation with adverse outcome of the second twin, where the respiratory distress syndrome was the major contributors to those below32 weeks, while birth asphyxia, and sepsis in those born 32 weeks and above. Conclusion:-A larger prospective study should be designed to appraise the management of twin pregnancy in Al- Yermouk Hospital. The higher rate of adverse outcome in the second twin in comparison with the first necessitates special emphasis since this may be related to the mode of the delivery.
Keywords
twin pregnancy; outcome of second twin

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