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Related Experiment Videos

Perinatal mortality in multiple pregnancy patients.

F P Meehan1, I M Magani, G Mortimer

  • 1Department of Obstetrics and Gynaecology, University College Galway, Ireland.

Acta Geneticae Medicae Et Gemellologiae
|January 1, 1988
PubMed
Summary

Perinatal mortality in multiple pregnancies significantly decreased from 1972-1984, with prematurity and low birthweight being key factors. Improved antenatal and neonatal care, including ultrasound, are crucial for reducing fetal loss in twins.

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatology
  • Neonatal Care

Background:

  • Multiple pregnancies present unique challenges in perinatal care.
  • Historically, prematurity and low birthweight have been primary contributors to fetal loss in twins.

Purpose of the Study:

  • To analyze trends in perinatal mortality for multiple pregnancies over a 12-year period.
  • To identify major causes of fetal loss and risk factors associated with adverse outcomes.

Main Methods:

  • Retrospective study of perinatal mortality in multiple pregnancies from 1972 to 1984.
  • Analysis of gestational age, birth presentation, twin order, and mode of delivery in relation to fetal loss.

Main Results:

  • Prematurity and low birthweight were the leading causes of fetal loss.

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  • Highest risk observed between 28-30 weeks gestation (306/1,000).
  • Significantly higher risk for breech deliveries (136/1,000) and second twins (1:14 ratio).
  • Perinatal mortality rate dropped from 98/1,000 to 39/1,000 between 1972-1978 and 1979-1984.
  • Regional analgesia in labor was associated with lower mortality (41/1,000 vs. 93/1,000).

    • Conclusions:

    • Advancements like ultrasound for early twin diagnosis and improved neonatal care have reduced mortality.
    • Vigilant antenatal care, bed rest, and intrapartum surveillance are essential.
    • External cephalic version for breech second twins and considering it as an alternative to cesarean section for transverse or breech presentations are recommended.