A COMPARATIVE STUDY OF PERINATAL OUTCOME OF SECOND BABY VERSUS FIRST BABY IN TWIN DELIVERY

Dr.Ruchi N.Thakur; Dr.Seema C.Kshirsagar

Volume : VII, Issue : IX, September - 2018

A COMPARATIVE STUDY OF PERINATAL OUTCOME OF SECOND BABY VERSUS FIRST BABY IN TWIN DELIVERY

Dr. Ruchi N. Thakur, Dr. Seema C. Kshirsagar

Abstract :

TYPE OF PRESENTATION: Original article

TITLE OF THE PAPER:�A COMPARATIVE STUDY OF PERINATAL OUTCOME OF SECOND BABY VERSUS FIRST BABY IN TWIN DELIVERY�

AUTHERS:Dr. Thakur Ruchi,Dr.Kshirsagar Seema

NAMEOFINSTITUTE:Department of Obstetrics and Gynaecology ,B.J.G.M.C. and Sassoon General Hospital,Pune-41101

INTRODUCTION:Twin pregnancy is becoming a problem of increasing dimensions worldwide with the dramatic increase in its incidence mostly attributable to assisted reproductive technologies (ARTs).¹Its incidence varies worldwide.

OBJECTIVE: To study the perinatal outcome of second twin during labour as against the first twin.

1 .To determine the effect of malpresentations, effect of mode of delivery on perinatal outcome of second twin, i.e. twin B.

2. To study the effect of maternal status, antenatal, intranatal complications, time interval between the delivery of two babies and its relation to the perinatal outcome of second twin.

3 To compare APGAR at 1 and 5 minutes of both the babies.

4. To compare differences in birth weights in both the twins with relation to perinatal deaths.

5. To observe the conventional management and to find out the suitable management for the delivery of second baby.

6. To find out the incidence of perinatal mortality of twins.

MATERIAL AND METHODS:

A prospective analytical study was undertaken with a view to analyze the vulnerability i.e. perinatal outcome of second twin during labour as against the first twin.

RESULTS:

The study findings emphasize the importance of appropriate management protocols directed towards counseling, frequent and regular antenatal check-ups, early admission of mothers, and proper care during intrapartum and immediate postpartum periods. Second twins should be managed more carefully during intranatal and early neonatal periods. Twin pregnancy can be effectively managed in a tertiary health care facility to optimize maternal and fetal care for improving perinatal outcome.

Perinatal mortality of monochorionic twins is much higher than that of dichorionic twins. Antepartum diagnosis of the type of placentation will help in identifying the twins at risk for twin to twin transfusion syndrome, discordant growth and greater perinatal mortality. Good antenatal care, early diagnosis, recognition and treatment of antenatal risk factors, prevention of preterm labour and close fetal surveillance, particularly of monochorionic twins and prompt therapeutic intervention of TTTS are necessary to reduce perinatal mortality. Strict intrapartum monitoring, experienced obstetricians to conduct delivery, liberal use of LSCS along with good neonatal intensive care especially for premature babies, will lead to better outcome.