Outcomes of Twin Pregnancy in Taksin Hospital, Bangkok Metropolitan Administration

Abstract

Outcomes of Twin Pregnancy in Taksin Hospital, Bangkok Metropolitan Administration

Apichai         Maharungruangrat            MD

Division of Obstetrics and Gynecology, Taksin Hospital

Objective: To determine the prevalence and outcomes of twin pregnancy delivery.

Study design: Descriptive study.

Subjects: Between January 1995 and December 2004, 438 twin pregnancies with more than 28 weeks of gestational age who delivered at Taksin Hospital and their neonates were enrolled.

Methods: Hospital records and operative reports were retrospectively reviewed.

Main outcome measures: prevalence of twin pregnancy delivery and outcomes.

Results: Prevalence of twin pregnancy delivery was 0.7% (1:142). The mean age was 26.8  5.8 years. 3.8% of these pregnancies did not attend antenatal care. Preterm labour and premature contraction were the most antenatal complications with responsible for 49.5%. Undiagnosed twin pregnancy before delivery occurred in 35.2%. The routes of delivery were vagina 52.3%, caesarean section for both twins 45.9% and caesarean section for the second twin 1.8%. During delivery, obstetric procedures were applied for the second twin more than the first twin especially for breech presentation. For neonates, the mean birth weight were 2,210  505 gm in  twin, 2,160  511 gm in   twin and 71.4% of them were less than 2,500 grams. The Apgar score below 7 at 5 minutes were 7.8% and 13.5% respectively. Congenital heart anomalies were found in 12 cases from the overall anomalies of 17 cases. Perinatal death was 30.8:1,000. In these deaths, 73.1% were preterm labour. Post-partum hemorrhage occurred in 3.0%.

Conclusions: The prevalence of twin pregnancy delivery was 0.7%. Undiagnosed twin pregnancy was still high. Premature contraction and preterm labour were the most complication during pregnancy. So, prematurity was the main cause of perinatal mortality. Then, early diagnosis, regular antenatal care and improvement or referral system from primary health care will decrease the complications and perinatal death in Taksin Hospital.

Key words: prevalence, twin pregnancy delivery, outcomes