A Hospital Based Study On Neonatal Outcome In Monochorionic And Dichorionic Twin Pregnancies

Background: Twin pregnancies account for 2 to 4% of the total number of births. Twin pregnancies are associated with signicantly higher morbidity and mortality than are singleton pregnancies. Among the twin pregnancies, Dichorionic pregnancies occur in 70% of the total twin pregnancies. Monochorionic twins are at higher risk twins for perinatal complications. The objective of the present study is to analyze neonatal outcomes associated with Monochorionic and Dichorionic twin pregnancies. Material and Methods: The study was Retrospective and Hospital based study conducted in Tertiary Care Hospital in Mumbai in 2018. The sample size was 50 (N=50). The patients with maternal co-morbidities like DM or other systemic illness were excluded from the study. The patients were divided into two groups, viz. Monochorionic or Dichorionic twins. The maternal age and its association with Monochorionic and Dichorionic twin pregnancy are studied. The neonatal outcome in Monochorionic and Dichorionic twins were then analyzed in terms of Birth weight, NICU stay, Neonatal deaths, etc. Statistical analysis: The maternal age and the various neonatal outcomes in Monochorionic and Dichorionic twin pregnancy were recorded. The student t test was used to compare the difference in both groups. Results: The maternal age was almost similar in both Monochorionic and Dichorionic twin pregnancies. The mean Birth Weight was more in Dichorionic group (p < 0.05). The Neonatal Outcomes like IUFD, TTTS and Discordant growth were more common in Monochorionic group as compared to Dichorionic group. Conclusion and Recommendations: Twin pregnancy rates have increased in the past 25-30 years, particularly in developing countries. The reasons may be more advanced maternal age and increased use of assisted reproductive techniques. The neonatal mortality and morbidity in twin deliveries is high in Monochorionic pregnancy as compared to Dichorionic pregnancy. The early identication of chorionicity in early pregnancy is necessary to prevent neonatal complications.

Retrospective study on socio-demographic factors responsible for acceptance of IUCD among postpartum women

Background: Despite the availability of modern and scientific measures, unacceptably high numbers of maternal deaths still occur in developing countries. Spacing methods of family planning may avoid maternal and infant deaths. The Government of India launched postpartum IUCD (PPIUCD) services in the year 2000; although acceptance of Postpartum IUCD is a real concern.Methods: The retrospective study was conducted in rural government hospital in Maharashtra during 2016 - 2017. We analyzed sociodemographic variables and acceptance of Postpartum IUCD among postpartum women. The sample size was 595 (N=595). The sociodemographic factors studied included age, type of delivery, sex of newborn, socioeconomic status, educational status, etc.Results: The total postpartum women included in the study was 595, out of which, 202 (34%) accepted for postpartum IUCD whereas 393 (66%) rejected for the same. The most common age group was 20-25 years (65%), followed by age group 25-30 years (30%). Primipara was the comment group (45%) and normal vaginal delivery was common (95%). The educational status of both, the postpartum women and their husband, showed statistically significant association with acceptance of postpartum IUCD (p<0.05).Conclusions: The acceptance Postpartum IUCD was low (34%). The women’s and their husband’s educational status is an important factor in acceptance of Postpartum IUCD (p<0.05). Due attention should be given to enhancing educational level of women, also effective counselling both for pregnant woman and her husband during ANC is required.