ABSTRACT
The objective of this study was to compare the perinatal outcome of first and second twin in terms of perinatal morbidity and mortality in vaginal delivery. This comparative study was conducted at Department of Obstetrics and Gynaecology, Lady Reading Hospital Peshawar from April 2006 to February 2007. Fifty patients with twin gestations admitted to labour ward for delivery at and above 36weeks´ gestation were selected according to the inclusion/exclusion criteria. Information including maternal age, parity, birth weight, Apgar score, perinatal morbidity and mortality of both twins were recorded on a semi structured proforma and analysed by chi square test using SPSS v 12. The differences of the Apgar scores at one minute and five minute were significantly increased in the second twin compared to that of the first twin [p =0.040, and 0.038 respectively]. The admission to nursery was also found to be significantly increased in second twins as compared to first twins [p = 0.43]. The perinatal morbidity was also found to be significantly increased in second twins than the first twins [p= 0.05], while neonatal mortality was not statistical significant. The perinatal outcome of vaginally delivered twins at or after 36weeks' of gestation showed that second twins are at greater risks of perinatal morbidity than the first born twins. But the early neonatal mortality was not significantly different between the two groups