Perinatal Outcome of First Twin Versus Second Twin in a Tertiary Care Centre
Prasenjit Sarkar *
Department of Obstetrics & Gynaecology, Malda Medical College and Hospital, India.
Gita Basu Banerjee
Chittaranjan Seva Sadan College of Obstetrics, Gynaecology & Child Health, Kolkata, India.
Sayan Chatterjee
Department of Paediatrics, Chittaranjan Seva Sadan College of Obstetrics, Gynaecology & Child Health, Kolkata, India.
*Author to whom correspondence should be addressed.
Abstract
Purpose of the Study: This study is to find out the perinatal outcome of the first baby versus the second baby in twin pregnancy with respect to gestational age, chorionicity, presentation, mode of delivery, birth weight, and twin-twin delivery time interval. This study is also conducted to find out specific neonatal outcomes, like neonatal death, need for mechanical ventilation, 5-minute Apgar score <7, NICU admission, and length of NICU stay in the first versus the second twin.
Methods: This hospital-based prospective observational study was conducted in the Dept of Obs and Gynecology, Chittaranjan Seva Sadan, Kolkata, from May 2020 to April 2021. During this period, 5891 patients were admitted for delivery. Out of them, there were 74 twin deliveries. 70 cases were taken for the study after satisfying the exclusion criteria. Study populations were chosen after satisfying the inclusion criteria of the patients who were getting admitted under the Obstetrics and Gynaecology department, Chittaranjan Seva Sadan. Statistical Analysis was performed with the help of Epi Info (TM) 7.2.2.2. EPI INFO is a trademark of the Centers for Disease Control and Prevention (CDC). Descriptive statistical analysis was performed to calculate the means with corresponding standard deviations (s.d.). The test of proportions was used to find the Standard Normal Deviate (Z) to compare the difference in proportions, and the Chi-square test was performed to find the associations. A t-test was used to compare two means. p<0.05 was taken to be statistically significant.
Results: The study about twin pregnancies commenced from May 2020 to April 2021. The study material consisted of 74 cases.70 cases were taken for the study after satisfying the exclusion criteria. The general incidence of twins in total live births and the perinatal outcome of the first twin versus second twin in respect to gestational age, chorionicity, presentation, mode of delivery, birth weight, delivery time interval between first and second twin were studied and analyzed & specific neonatal outcome like neonatal death, need for mechanical ventilation APGAR score <7 at 5 minutes, neonatal intensive care unit admission, length of neonatal intensive care unit stay in the first versus second were observed.
Conclusion: The current study reveals that perinatal morbidity and mortality were higher for second twins when compared with first twins in relation to preterm delivery. Regular antenatal check-ups for all mothers carrying twins will improve the pregnancy's outcome.
Keywords: Twin, perinatal outcome, APGAR score, birth weight