TWIN DELIVERY: PERINATAL OUTCOME OF THE SECOND BORN TWIN

Abstract

Objective: The objective of this study was to compare the perinatal outcomeof first and second twin in terms of perinatal morbidity and mortality in vaginaldelivery.

Methodology: This comparative study was conducted at Department of Obstetricsand Gynaecology, Lady Reading Hospital Peshawar from April 2006to February 2007. Fifty patients with twin gestations admitted to labour wardfor delivery at and above 36weeks´ gestation were selected according to the inclusion/exclusion criteria. Information including maternal age, parity, birthweight, Apgar score, perinatal morbidity and mortality of both twins were recordedon a semi structured proforma and analysed by chi square test using SPSS v 12.

Results: 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 alsofound to be significantly increased in second twins as compared to first twins(p = 0.43). The perinatal morbidity was also found to be significantly increasedin second twins than the first twins (p= 0.05), while neonatal mortality was notstatistical significant.

Conclusion: The perinatal outcome of vaginally delivered twins at or after 36 weeks' of gestation showed that second twins are at greater risks of perinatalmorbidity than the first born twins. But the early neonatal mortality wasnot significantly different between the two groups.