ABSTRACT
INTRODUCTION: Twin pregnancy is a high-risk pregnancy with different prevalences in different regions of the world which is on the rise due to growing use of assisted reproductive technology. The objective of this study is to determine the frequency of twin pregnancy and the neonatal outcome of these pregnancies. MATERIALS AND METHODS: This is a descriptive-analytic study conducted in 2004-2007 in Mo'tazedi Hospital, Kermanshah on 142 twin deliveries as well as the singleton deliveries before and after twin pregnancy as the control group. The required information, including maternal age, gestational age, newborn's gender, presentation of twins, birth weight, Apgar score, fetal anomalies, and neonatal mortality were extracted from medical files and analyzed statistically. FINDINGS: After assessment of 29,438 deliveries performed from 2004 to 2007, the frequency of twin pregnancy was found out to be 1 in 208 cases (48 %). The mean age of mothers was higher in twin pregnancies. The mean gestational age of twin pregnancy was 34.3 weeks. Apgar score and neonatal weight were significantly lower in twin pregnancy compared to singleton pregnancy (p < 0.001). Furthermore, visible anomalies and mortality were significantly higher in neonates born to twin pregnancies compared to singleton pregnancies (p < 0.0001 and p = 0.009, respectively). The ratio of male to female neonates was 1. CONCLUSION: This study indicated that twin pregnancy is a high-risk condition and entails greater neonatal complications compared to singleton pregnancy. Therefore, it is recommendable to have greater perinatal care and perform deliveries in well-equipped centers under supervision of an obstetrician.
ABSTRACT
OBJECTIVE: Hypertension disorders are associated with higher rates of maternal, fetal, and infant mortality, and severe morbidity, especially in cases of severe preeclampsia, eclampsia, and HELLP syndrome. The aim of the study was to determine maternal outcomes in pregnant women with severe preeclampsia. DATA SOURCE: The data source consisted of 349 cases with severe preeclampsia. DESIGN: A cross-sectional study was undertaken on 349 cases of severe preeclampsia in pregnancy. SETTING/PERIOD: The patients selected for this study were from those who presented at Kermanshah University of Medical Sciences, Department of Obstetrics and Gynecology during 2007-2009. MATERIALS AND METHODS: Statistical analysis was performed using SPSS 16 software and conducting Chi square and independent sample t tests. Demographic data involving age, parity, gestational age, clinical, and laboratory findings were recorded from the medical files. In addition, delivery route, indications of cesarean delivery, and maternal complications were determined. RESULTS: Of the 349 severely preeclampsia cases, among the 22 cases (6.3 %) who had suffered from eclamptic seizers, 17 cases (77.3 %) were in the age group of 18-35 years (P = 0.351) and 13 cases (59.1 %) in the gestational age group of 28-37 weeks (P = 0.112). One case (0.3 %) was demonstrated to have HELLP syndrome. Placental abruption was obstetric complication in 7.7 % (27 cases). Delivery route was vaginal in 120 cases (34.4 %), while 229 cases (65.6 %) underwent cesarean delivery. The most frequent maternal complication (37 cases) reported was coagulopathy (10.6 %). CONCLUSIONS: We concluded that severe preeclampsia and eclampsia are associated with higher rates of maternal severe morbidity and that these two factors still remain the major contributors to maternal morbidity in Iran.
