Delivery Methods, Perinatal Mortality and Obstetric Complications in Multiple Pregnancies

Abstract

OBJECTIVE: To evaluate the outcome of multiple pregnancies, which were in the high- risk pregnancy groups and to investigate the factors playing role at perinatal mortality. STUDY DESIGN: Ninety-six cases with multiple pregnancies delivered at Gynecology and Obstetrics Clinic of Research and Training Hospital of The Medical Faculty of Yüzüncü Yil University between January 1997-January 2004 were included in this study. Ninety-four twin pregnancies and 2 triplet pregnancies were reviewed retrospectively and then mortality rates, congenital anomalies, complications and delivery characteristics of these cases were analyzed. The statistical analysis was performed by SPPS (The Statistical Computer Software, version 9.05, Chicago, Illinois). RESULT(s): The incidence was 1.66% (94/5,632) for twin pregnancies; and 0.035% (2/5,632) for triplet pregnancies. The antenatal follow-up rate for the pregnant women during this study was 26.36%. The mean age of pregnant women was 28.3±5.65 and mean gestational age was 35.18±5.35 weeks. Fifty-three of these cases (55.2%) were delivered vaginally, while 42 cases (43.75%) were delivered by cesarean section. In one case, first fetus was delivered vaginally and the second fetus by cesarean section. Apgar scores (1-5 minutes) in 16 newborns were 0-0, in 56 newborns were below 7 and in 124 newborns were above 7. Birth weights were below 1000 gr. in 30 (15.5%) newborns, were between 1000 and 2499 gr. in 88 newborns (45.4%), and were above 2500 gr. in 76 newborns. Perinatal and neonatal mortality was highest among the babies with birth weights below 1500 gr. and gestational age under 27 weeks. Perinatal mortality rate was found to be 0.82% and neonatal mortality rate to be 0.98% among multiple pregnancies. CONCLUSION(s): The frequency of multiple pregnancies was consistent but the perinatal mortality rate was higher than the literature. Immaturity and prematurity were determined as the important factors increasing perinatal mortality.