[Adaptational problems and diseases in twins with a gestational age over 32 weeks]

This retrospective study is carried out at the State University Hospital "Maĭchin dom" for the period 1991-1995, including 207 newborns from multiple pregnancies. Babies are divided in two groups according to gestational age: I group--32-37 gestational weeks (123 babies) and II group--over 37 gestational week (84 babies). The majority of babies are born by a normal mechanism, followed by those, delivered by cesarean section and in a small number of cases in the second group, the first twin is born by vacuum extraction, while the second one-by a normal mechanism. Having in mind the Apgar score and pH from umbilical artery, the condition of the newborn depends mostly upon the degree of maturity and less on the way of delivery. Twins in the second group show a definite tendency of intrauterine growth retardation (mean weight below the 10th percentile according to the intrauterine growth charts). A significant part of the neonatal period problems comprise in relative immaturity and intrauterine growth retardation. The analysis of neonatal morbidity shows a prevalence of lung pathology in the 32-37 gest. weeks group, followed by foeto-maternal infection (mostly in the first twin), metabolic and haematological disorders. In the group of twins over 37 weeks of gestation highest is the frequency of adaptation problems, followed by inborn infections. The conclusion is made that newborns from multiple pregnancies are of higher risk for increased morbidity and adaptation problems during the neonatal period.