Maternal and Perinatal Outcome in Multifetal Gestation in Rural Population: A Hospital Based Prospective Study

ABSTRACT

Background: Living in a rural or remote location can make access to advanced obstetric and neonatal care difficult and may increase the risk of severe maternal and perinatal morbidity. This retrospective observational study of 30 women with twin pregnancy was conducted to evaluate pregnancy related complications in the mother and neonatal outcome in a rural population. Materials & Methods: This retrospective study was conducted at Shri Jawahar Government district Hospital, Jaisalamer, Rajasthan. 30 consecutive women with twin pregnancies that were admitted either as registered antenatal patients or referral cases were studied. Individual patient parameters like age, parity, duration of gestation, physical examination, mode of delivery, antepartum, intrapartum and postpartum complications were tabulated. Neonatal morbidity and mortality in the first week were also noted. Results: Majority of patients (60%) studied were in the age group of 26 – 35 years (mean age – 29 years). Preterm labor was the most frequently encountered complication seen in 66.66% patients, followed by anemia (63.33%), gestational hypertension (26.66%), premature rupture of membranes (23.33%) and Intra uterine growth retardation (10%). Pregnancy was uneventful in 8 patients. No maternal death was recorded in the study group (table 3). 21 neonatal was admitted in NICU and mostly neonates had APGAR score <7 at one minute and 1.33% neonates had died in our study. Conclusion: We concluded that regular and more frequent antenatal checkup with liberal hospital admission policy for multifetal gestation is essential to reduce adverse pregnancy outcome in such women. There is a need for effective implementation of strategies to ascertain the risk factors, incidence and indications for operative deliveries.