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En la práctica, es muy frecuente asociar las gestaciones gemelares monocoriales (MC) con embarazos complejos o complicados, utilizando ambos términos en forma intercambiable. Sin embargo, no lo son; el dinamismo es protagonista en los sistemas complejos, pero no en los complicados. Para entender a la embarazada con una gestación MC como un sistema complejo, primero se desarrollarán las características principales de los embarazos MC; su placenta es una de las principales responsables de los problemas. Luego se analizará el embarazo MC desde la complejidad, identificando las características del sistema y sus complicaciones como propiedades emergentes.
In practice, it is very common to associate monochorionic (MC) twin pregnancies with complex or complicated pregnancies, using both terms interchangeably. However, these are not synonyms; dynamism is the protagonist in complex systems, but not in complicated ones. In order to understand a MC pregnancy as a complex system, it is necessary to first look into its main characteristics. The placenta is one of the main sources of problems. Then, the MC pregnancy has to be analyzed from the perspective of complexity, identifying the system characteristics and its complications as emergent properties.
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Humans , Female , Pregnancy , Twins, Monozygotic , Pregnancy, Twin/psychology , Placenta , Pregnancy Complications , ChorionABSTRACT
Background: Twin pregnancy, involving the presence of two fetuses in the uterus, has intrigued humanity across history. Key challenges presented by twin pregnancies include prematurity, low birth weight (LBW), intrauterine growth restriction (IUGR), birth trauma, asphyxia, and congenital anomalies. Preterm delivery poses the most significant risk, contributing to elevated perinatal mortality, neonatal morbidity, and long-term health issues for twins.Methods: Retrospective study at Smt NHL Municipal Medical College analyzed 80 twin pregnancies from July 2022 to January 2024. Data included patient demographics, complications, and neonatal outcomes, informing findings through data analysis.Results: In this study, the majority were under 30 years old (56%) and primigravida (68%), with 48% having a BMI over 30. Common complications included preterm labor (70%), pregnancy-induced hypertension (27.5%), and gestational diabetes (20%). Most twin pregnancies were dichorionic diamniotic (80%). Caesarean section rate was 47.5%. Deliveries mostly occurred between 33-36 weeks gestation, with cephalic-cephalic presentation being most common (40%). Neonatal complications were primarily prematurity (50%), resulting in high NICU admissions (62%) and a neonatal death rate of 13.76%.Conclusions: Multiple pregnancies require early diagnosis and vigilant care to reduce maternal and perinatal risks. Access to skilled healthcare providers and advanced facilities is crucial. Antenatal care must be strengthened for timely referrals. Ultrasonography aids early complication detection. Further advancements and awareness are essential for improved outcomes.
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Mono amniotic twin pregnancy discordant for anencephaly (MATDA) is a rare occurrence. 29-year-old primi gravida was diagnosed with mono amniotic twin one baby anencephaly and other baby normal at 14 weeks of gestation during NT scan. Patient was counselled regarding selective termination & expectant management outcomes. They wanted to continue the pregnancy with expectant management. She developed pregnancy induced hypertension around 30 weeks which was managed by oral labetolol. Caesarean section was performed at 36 weeks of gestation, with first baby normal & second baby Anencephaly. The normal newborn infant was discharged from SNCU without any complications. Expectant management of a mono amniotic twin gestation discordant for anencephaly diagnosed at the first trimester is associated with a favourable outcome for the unaffected foetus.
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A multi-fetus pregnancy occurs when there are two or more embryos or fetuses present at once. The most obvious anatomical position of the fusion of the fetal components can be used to classify conjoined twins, a rare congenital abnormality with an incidence of 1.5 per 100,000 births. A 29-year-old multiparous pregnant woman came to Arifin Achmad hospital, Pekanbaru, Riau. The patient received a referral from an obstetrician because there was a foetal abnormality. The patient did not have any complaints when he came to the hospital. The results of the ultrasound examination showed that the intrauterine Gemelli foetus was alive and had conjoined twins (parapagus-dicephalus). There are 2 pairs of legs, 2 pairs of hands, 2 heads, and 2 hearts. The patient was then planned for abdominal termination of pregnancy. A caesarean operation was performed, and a baby boy was born with 2 heads, 4 arms, 2 hearts, and 2 legs. With the baby's birth weight of 4200 gm, birth length of 47 cm, and Apgar score of 7/8, anal atresia was also found in the fetus. Pregnancy with multiple fetuses carries a high risk of maternal and perinatal morbidity and mortality. The risk of complications for both the mother and the child must be reduced by the early diagnosis of multi-fetus pregnancies with conjoined twins.
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This paper reports the maternal and fetal outcomes of three twin pregnancies with chronic hypertension and obstructive sleep apnea-hypopnea syndrome (OSAHS) who were treated with continuous positive airway pressure (CPAP). All three women with twin pregnancies were diagnosed with chronic hypertension. Furthermore, symptoms such as snoring and apnea assisted the diagnosis of OSAHS through polysomnography monitoring. Case 1 was treated with CPAP at 28 gestational weeks. The blood pressure increased gradually after the first month of CPAP treatment, with an elevated urine protein concentration. At 34 gestational weeks, the pregnant woman underwent a cesarean section due to the development of hemolysis, elevated liver enzymes, and low platelet syndrome. Case 2 was treated with CPAP at 11 gestational weeks, with stable blood pressure throughout the pregnancy, and was delivered through cesarean section at 37 weeks of pregnancy. Case 3 started CPAP at 13 gestational weeks for four months, and increased blood pressure and urine protein were observed. Medication brought the blood pressure down, and urine protein became negative. At 32 gestational weeks, a cesarean section was performed because of premature rupture of the membrane. Her CPAP treatment continued till delivery with good maternal and infant outcomes. The treatment outcomes of the three cases suggest that CPAP may prolong the time of blood pressure rise among twin pregnancies where chronic hypertension and OSAHS coexist, which potentially reduces the occurrence of adverse maternal and infant outcomes.
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Preterm birth is the most common maternal complication in twin pregnancies. In recent years, cervical cerclage has been of long-standing interest in the prevention of preterm birth in twin pregnancies. However, its clinical application in the treatment of cervical insufficiency of twin pregnancies remains a controversial subject. In addition, infection or inflammation conditions are considered to be closely related to the perinatal outcomes of twin pregnancies after cervical cerclage. This paper reviews the research progress on cervical cerclage in twin pregnancies, recommending cervical cerclage for twin pregnancies with cervical length≤15 mm or cervical dilatation, while it is not suggested for those with cervical length of 15-25 mm or history-indicated cervical cerclage. The clinical significance of preoperative evaluation of intraamniotic infection or inflammation of twin pregnancies needs to be further explored, but it is necessary to avoid the effect of antibiotic use on the evaluation of surgical effects.
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Objective:To investigate the feasibility and clinical effects of the application of augmented reality (AR) navigation on assisted design of the chimeric twin-paddled anterolateral thigh perforator flap (ALTPF) in reconstruction of soft tissue defects in extremities.Methods:From June 2017 to June 2023, 8 patients with soft tissue defects in extremities received reconstruction of chimeric twin-paddled ALTPF designed with the assistance of AR navigation in Department of Hand & Foot Microsurgery Orthopaedics, Guigang City People’s Hospital. All of them were traffic accidents or machine injuries, with 3 cases of calf, 2 cases of ankle, 1 case of foot, and 2 cases of hand defects. All the wounds were wide or irregular (defect sized 14 cm×14 cm-25 cm×13 cm). The images of bilateral thighs were acquired by CT angiography preoperatively. The dominant side and dominant perforators were selected. Three dimensional reconstruction was performed by Mimics software. AR technology was applied to guide the design and harvest of the chimeric twin-paddled ALTPF. Flap area was 15 cm × 16 cm to 26 cm × 14 cm. The donor site was sutured directly. Follow-up with outpatient visits or WeChat images and videos at 1, 3, 6 and 12 months postoperatively to record the appearance, colour, texture, recurrence of infection, and knee extension function of the flap donor site.Results:According to the preoperative design, the perforator flaps were harvested and transferred in all the 8 patients. All flaps survived and the recipient and donor sites healed in one stage. All patients entered postoperative follow-up for 3 to 12 (mean, 8.6)months. The colour and texture of the flaps were excellent, and the appearance of donor and recipient sites was satisfactory. Two patients with hand injuries were evaluated using the brief Michigan Hand Outcomes Questionnaire (MHQ), with scores of 43.74 and 81.25, respectively. Six patients with lower limb injuries were evaluated using the Maryland foot score, with scores of 2 excellent, 3 good and 1 fair.Conclusion:The application of AR navigation can effectively assist the design of a chimeric twin-paddled ALTPF. It also provides an effective basis for clinical personalised flap design.
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Objective@#To construct a prediction model for preeclampsia (PE) risk in twin-pregnant women, so as to provide the basis for early screening and prevention of PE.@*Methods@#A total of 467 twin-pregnant women who underwent prenatal examination and delivered at Huzhou Maternal and Child Health Hospital were selected. Sixty cases with preeclampsia (PE) were included in the case group, and 60 women without PE were included in the control group. General information, blood biochemical indicators and uterine artery resistance index (UtA-RI) were collected. A logistic regression model was used to screen predictive factors and establish a nomogram. The Bootstrap method was performed for the internal validation; the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis were employed to evaluate the discrimination, calibration and clinical utility of the nomogram, respectively.@*Results@#In the case group, there were 47 individuals (78.33%) aged younger than 35 years, 21 individuals (35.00%) with pre-pregnancy body mass index (BMI) of 25 kg/m2 and above, and 33 individuals (55.00%) with in vitro fertilization. In the control group, there were 57 individuals (95.00%) aged younger than 35 years, 8 individuals (13.33%) with pre-pregnancy BMI of 25 kg/m2 and above, and 39 individuals (65.00%) with natural pregnancy. Multivariable logistic regression analysis identified age, pre-pregnancy BMI, method of conception, placental growth factor (PLGF) and UtA-RI as risk prediction factors for PE in twin-pregnant women. The established nomogram had an area under the ROC curve of 0.827 (95%CI: 0.755-0.899), a sensitivity of 0.767, a specificity of 0.733, a good discrimination and calibration, and a relatively high clinical net benefit.@*Conclusion@#The nomogram established by age, pre-pregnancy BMI, method of conception, PLGF and UtA-RI has a good predictive value for the risk of PE in twin-pregnant women.
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@#Hydatidiform mole coexistent with a live fetus (CMCF) is a rare entity occurring in 1:20,000 to 1:100,000 pregnancies. Three mechanisms of this type are possible: (1) a singleton pregnancy consisting of partial mole with a triploid fetus, (2) a twin gestation consisting of an androgenic complete hydatidiform mole with a biparental diploid fetus, and (3) a twin gestation consisting of a biparental diploid fetus with a normal placenta and a partial hydatidiform mole (PHM) with a triploid fetus. The abnormal triploid fetus in a partial mole tends to die in the first trimester while the fetus coexisting with a complete or partial mole in the dizygotic twin pregnancy has a chance to survive. Early detection and diagnosis of a molar gestation with a viable fetus is needed to allow medical interventions, if available. Three cases of complete mole with a twin fetus (CMTF) that were diagnosed in the prenatal period by ultrasonography will be presented. This report will also discuss the indications for continuing the pregnancy, and review the literature on the recommended prenatal care, intrapartum management, and postpartum surveillance. This report aims to encourage others to document cases of CMTF in order to arrive at a consensus regarding its optimal management.
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Hydatidiform Mole , Pregnancy, TwinABSTRACT
ObjectiveTo establish the Shanghai twin birth cohort （STBC） and analyze the effects of genetic factors， shared environment， and non-shared environment interactions on birth health and growth and development of newborns. MethodsBased on the population-wide birth cohort in Shanghai， a comprehensive survey was conducted on the families with double and multiple babies born after January 1， 2015 to collect information on birth health， growth and development， and the family environment of the babies. ResultsBy December 31， 2021， a total of 7 195 pairs （14 405 cases） of twins were successfully included in the STBC survey. The average birth length of twins was 47.2 cm and average birth weight was 2 465.3 g. Heterozygous twins accounted for 69.05% and preterm babies accounted for 57.07%. The average age of the mothers of twins was 31.82 years， and the average age of the fathers was 33.87 years， with more than 80% of the parents having a college degree or above. 44.50% of the mothers used assisted reproductive technologies， 7.40% had illnesses during pregnancy， and 15.90% were exposed to passive smoking during pregnancy. During the survey period， the average monthly increase in the length of the twin infants was 2.09 cm， and the average monthly weight gain was 0.53 kg. ConclusionThe incidence of adverse outcomes such as maternal cesarean section rate， preterm birth， and low birth weight is higher in the twin birth population. Information on birth health as well as growth and development in childhood and adolescence in the twin birth population is collected based on STBC， which can provide a solid data foundation for studying children’s chronic non-communicable diseases， psychological and behavioral disorders and other complex health problems caused by the combined effects of genetics and the environment.
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Objective To design an intelligent surgery management system for closed-loop management of the entire surgical process.Methods An intelligent surgery management system was developed with digital twin technology,Microsoft Visual Studio 12.0 development toolset and C# language,which realized multi-modal data acquisition with IoT devices such as radio frequency identification(RFID)bracelets,mobile terminals and positioning base stations and real-time data mirroring and gathering by change data capture(CDC)technology.There were four functional modules included in the system developed,including the modules for IoT device management,transfer process recording,intelligent management command chamber and surgical progress reminder.Results The system developed could provide real-time feedback on the operation status of all aspects of surgery,shorten the lengths of preoperative positioning and surgical reception and improve the satisfaction of both doctors and patients.Conclusion The system developed achieves closed-loop management and complete data traceability of the entire surgical process,helping to form an efficient and safe surgical operation management system.[Chinese Medical Equipment Journal,2024,45(1):42-46]
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The medical meta verse and digital twin are set to revolutionise healthcare.Like all emerging technologies their benefits must be weighed against their ethical and social,impacts.If we consider the advances of medical tech-nology as an expression of our values,such as the pursuit of knowledge,cures and healing,an ethical study allows us to align our values and steer the technology towards an agreed goal.However,to appreciate the long-term consequents of a technology,those consequences must be considered in the context of a society already shaped by that technology.This paper identifies the technologies currently shaping society and considers the ethical,and social consequences of the medical metaverse and digital twin in that future society.
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@#Objective To determine different patterns of fetal growth dissonance in twin pregnancies and their predictive role in obstetric adverse outcomes.Methods The medical records of 531cases of twin-pregnancy women who underwent labor examination and delivery in our hospital from January 2014 to december 2021 were retrospectively analyzed.According to the ultrasound parameters during the prenatal examination,the inconsistencies between twins were divided into four modes:mode 1:no significant inconsistencies group(268cases),Mode 2:early progressive inconsistencies(23cases),mode 3:early inconsistencies with plinosis(91cases)and mode 4:late inconsistencies(149cases).The dynamic changes of each model and its correlation with adverse outcomes were investigated.Results Pattern 2 and Pattern 3 inconsistencies>10%(20.5 and 20.7 weeks of gestation)and>20%(27.7 and 26.3weeks of gestation)occurred at similar times.Mode 2 had the highest rate of inconsistent progression(0.92%/week),which peaked at 23.7%at 36weeks of gestation.Mode 3 progressed at a slower rate(0.49%/week),with a smaller variance after 20weeks(from 13.3%at 20weeks to 16%at 36weeks).The onset time of pattern 4 inconsistencies was>10%at 29.8weeks of gestation,and the peak inconsistencies(14.8%)were lower than pattern 2 and pattern Using mode 1(no significant inconsistency)as a reference,after adjusting for relevant covariates,mode 2 and 3 were risk factors for preterm birth and preeclampsia at 34 and 32weeks of gestation,mode 2 was a risk factor for 5-minute Apgar score<7,and mode 2,3,and 4 were risk factors for newborn birth weight<10th percentile.Conclusion According to the occurrence,development and intensity of neonatal growth dissonance,four different dissonance patterns were identified to be associated with different obstetric outcomes.These models provide more predictive information than the single point in time when measurements of fetal size are inconsistent,which is commonly used.
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BACKGROUND: Currently, there is limited evidence on termination of pregnancy for cojoined twin documented with only 33 cases reports to-date. This study aimed to describe the clinical and procedure characteristics of second trimester dilation and evacuation(D&E) for cojoined twins at later gestation. METHODS: This retrospective case series was conducted at a tertiary-level hospital in Ethiopia from February 2023- July 2023. Women who had a cojoined twin pregnancy in later gestation (≥20 weeks) and underwent second trimester D&E were retrospectively studied through chart review. Clinical presentation, D&E procedural description, and procedure outcomes of the cases were analyzed. RESULTS: Three women who had a cojoined twin in later gestation (≥20 weeks) and underwent second trimester D&E were identified. In two of the cases, a two- day cervical preparation with laminaria was used to prepare the cervix while overnight Foley catheter (1-day preparation) was used for similar purpose in the third case. A cervical dilation of 3 cm was achieved in all cases and was deemed adequate to proceed with the procedure by the managing physicians. Intra-operative ultrasound guidance was utilized in all the cases and there were no complications encountered. CONCLUSION: Our case series underscores the importance of achieving adequate cervical preparation, utilization of intra-operative ultrasound guidance, and handling the procedure by the most experienced provider, in increasing the safety and effectiveness of D&E procedures for conjoined twin at later gestation.
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Humans , Female , Pregnancy Trimester, Second , Strategic Evacuation , Cervix Uteri , Pregnant Women , Pregnancy, TwinABSTRACT
Introducción: La disfunción placentaria origina complicaciones fetales; de manera más frecuente, la restricción del crecimiento intrauterino y la preclampsia. Objetivo: Identificar el patrón estereológico en placentas gemelares, y su relación con la corionicidad y el peso del recién nacido. Métodos: Se realizó un estudio descriptivo en una muestra de 16 gestantes gemelares, 25 placentas y 32 recién nacidos. Se estudiaron las variables peso del recién nacido, número de vellosidades, superficie vellositaria total, área vellositaria, área de nodos, densidad óptica de fibrina en la superficie vellositaria y densidad óptica de fibrina alrededor del vaso. Resultados: Existió relación directa entre el número de vellosidades y la superficie vellositaria total. En las placentas monocoriónicas hubo predominio de recién nacidos bajo peso. Se percibe una diferencia en los resultados de área, según el tipo placentario y la región topográfica. En las placentas monocoriales se observó mayor área, tanto de la vellosidad placentaria como en los nodos sincitiales, siendo el área de la vellosidad mayor en la periferia placentaria, y el área de nodos sincitiales en la región 4 cm del cordón umbilical. Conclusiones: La estereología microscópica a nivel pericordón, a 4 cm del cordón y en la periferia del disco placentario, arrojó diferencias significativas para el área de la vellosidad y la densidad óptica de fibrina en la superficie de la vellosidad. Los valores promedio para el área de nodos sincitiales y la densidad óptica de fibrina alrededor del vaso no mostraron diferencias estadísticamente significativas. Es la corionicidad un predictor del bajo peso al nacer(AU)
Introduction: Placental dysfunction causes fetal complications; more frequently, intrauterine growth restriction and preeclampsia. Objective: To identify the stereological pattern in twin placentas, and its relationship with chorionicity and weight of the newborn. Methods: A descriptive study was carried out in a sample of 16 women with twin pregnancy, 25 placentas and 32 newborns. The variables weight of the newborn, number of villi, total villous surface, villous area, node area, optical density of fibrin on the villous surface and optical density of fibrin around the vessel were studied. Results: There was a direct relationship between the number of villi and the total villous surface. In monochorionic placentas there was a predominance of low birth weight newborns. A difference is observed in the area results according to the placental type and the topographic region. In monochorionic placentas, a greater area was observed, both in the placental villus and in the syncytial nodes, with the villus area being greater in the placental periphery and the area of syncytial nodes in the region 4 cm from the umbilical cord. Conclusions: Microscopic stereology at the perichordal level, 4 cm from the cord and at the periphery of the placental disc showed significant differences for the villus area and fibrin optical density on the villus surface. The average values for the area of syncytial nodes and the optical density of fibrin around the vessel did not show statistically significant differences. Chorionicity is a predictor of low birth weight(AU)
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Humans , Female , Pregnancy , Placental Insufficiency/diagnostic imaging , Chorionic Villi , Pregnancy, Twin , Epidemiology, DescriptiveABSTRACT
Arthrogryposis multiplex congenita (AMC) is a rare congenital syndrome characterized by multiple joint contractures. It usually affects the joints of hands, wrists, elbows, shoulders, hips, feet, knees, jaw and back. This case report discusses a mild variety of AMC in a twin where the other twin had no musculoskeletal abnormalities. There has been no published case report of such a case in a twin delivery. Prompt recognition of the syndrome complex and early start of stretching exercises and physiotherapy is the mainstay treatment protocol to give relative contracture free mobility to the child.
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Twin reversed arterial perfusion (TRAP) sequence results from aberrant and asymmetrical twinning. It is a rare but serious complication of monozygotic twin pregnancies. It is characterized by a normally formed fetus that shows features of heart failure, and an acardiac twin. A 26-year-old pregnant woman, gravida 6, para 5, with mono-chorionic di-amniotic twin pregnancy at her 20th week of gestation, was diagnosed with TRAP sequence. Both the pump twin and the acardiac co-twin did not display any cardiac activity. Termination of pregnancy was accomplished by a successful vaginal birth after cesarean section (VBAC) following five prior cesarean sections. Proper and early diagnosis of TRAP sequence can aid in treatment selection and pump twin salvage. Induction of labor by both misoprostol and intracervical balloon catheter showed to be safe and effective in a woman with a uterine scar resulting from five prior cesarean sections.
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Background: Twin pregnancies present significant challenges for obstetricians worldwide. Although they account for a relatively small percentage of global births, their occurrence varies across different regions. The increasing utilization of assisted reproduction techniques and the advancing maternal age contribute to the growing incidence of twin pregnancies. As a result, it is essential to understand the implications and risks associated with multiple gestations. The objective was to determine the burden of twin pregnancies, identify maternal risk factors, assess fetal outcomes, and explore potential associations between these factors.Methods: Data were collected from hospital records, including information on maternal age, parity, method of conception, gestational age, pregestational body mass index (BMI), and family history. Maternal and fetal complications, mode of delivery, and high-risk conditions in the fetuses were documented. Statistical analysis was performed using the Fisher-exact test.Results: The study included 78 twin pregnancies. The majority of women (78.2%) fell within the age range of 21-30 years. The majority of women (70.5%) had a normal pregestational BMI. Preterm births occurred in 24.3% of twin pregnancies. Hypertensive disorders (24.0%) and foetal malpresentation (38.0%) were common indications for cesarean section. Fetal complications included intrauterine growth restriction (11.5%), birth weight discordance (25.0%), early neonatal deaths (14.7%), and low APGAR scores (16.0%).Conclusions: Twin pregnancies present challenges due to the increased risks of maternal complications, preterm birth, and adverse fetal outcomes. The study emphasizes the need for careful management and monitoring of twin pregnancies to improve outcomes.
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Conjoined twins, popularly referred as Siamese twins, are twins joined in utero, affecting less than 1% of the monozygotic pairs. The frequency of conjoined twins has prevalence of 1.5 in 1 lakh births and thoracopagus is the most common. Early diagnosis is important as many patients opt for termination because of the grave prognosis. Though the prognosis of conjoined twin is generally low, there is limited evidence regarding the optimum method of termination of the pregnancy particularly in advanced gestational age. We hereby, report a rare case of successful medical termination of thoraco-omphalopagus twins at 23 weeks and 2 days of gestation. A 27-years old, 2nd gravid woman with previous vaginal delivery diagnosed with conjoined thoraco-omphalopagus twin pregnancy at 23 weeks and 2 days of gestation after the detailed ultrasonographic evaluation. Proper assessment and counselling were done regarding prognosis. Different options of termination were discussed and patient opted for medical termination of pregnancy with possibility of reverting to hysterotomy in case difficulty is encountered. After a 2 day of cervical preparation, a successful vaginal delivery was conducted. Even though this is an experience from a single case, medical termination can be safely preformed in carefully selected cases of conjoined twins beyond 20 weeks of gestation. The adequate cervical preparation, pain control and careful monitoring of the procedure are critical for optimal outcome.
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Background: Twin pregnancies present significant challenges for obstetricians worldwide. Although they account for a relatively small percentage of global births, their occurrence varies across different regions. The increasing utilization of assisted reproduction techniques and the advancing maternal age contribute to the growing incidence of twin pregnancies. As a result, it is essential to understand the implications and risks associated with multiple gestations. The objective was to determine the burden of twin pregnancies, identify maternal risk factors, assess fetal outcomes, and explore potential associations between these factors.Methods: Data were collected from hospital records, including information on maternal age, parity, method of conception, gestational age, pregestational body mass index (BMI), and family history. Maternal and fetal complications, mode of delivery, and high-risk conditions in the fetuses were documented. Statistical analysis was performed using the Fisher-exact test.Results: The study included 78 twin pregnancies. The majority of women (78.2%) fell within the age range of 21-30 years. The majority of women (70.5%) had a normal pregestational BMI. Preterm births occurred in 24.3% of twin pregnancies. Hypertensive disorders (24.0%) and foetal malpresentation (38.0%) were common indications for cesarean section. Fetal complications included intrauterine growth restriction (11.5%), birth weight discordance (25.0%), early neonatal deaths (14.7%), and low APGAR scores (16.0%).Conclusions: Twin pregnancies present challenges due to the increased risks of maternal complications, preterm birth, and adverse fetal outcomes. The study emphasizes the need for careful management and monitoring of twin pregnancies to improve outcomes.