Twin births and their complications in women of low socioeconomic profile

Objective: To determine the frequency of twin births and their foetomaternal complications in women of low socioeconomic profile.Methods: The cross-sectional study was conducted from January 2009 to December 2010 at the Obstetrics and Gynaecolgy Unit I, Civil Hospital, Karachi. Patients with twin pregnancy giving birth beyond 24 weeks, were selected by non-probability purposive sampling. Data on patient characteristics, gestation, antepartum and peripartum complications, chorionicity, mode of delivery and perinatal outcome was recorded and analysed through SPSS 16.Results: Out of 6077 deliveries during the study period, 119 twin births gave a frequency of 19.58/1000 births. Patients mean age was 27.51±4.2 years, mean parity 2.4±2.2 and mean gestational age was 34.76±3.4 weeks. Unbooked and referred patients were 96 (80.67%).Final paired outcome was alive twin pairs in 74 (62.18%) cases, stillbirth in 7 (5.88%), neonatal deaths in 10 (8.40%). Perinatal mortality rate was 277/1000 twin births. Most frequent foetal complications were low birth weight (n=84; 70.58%), pre-term births (n=70; 58.82%) and intrauterine growth restriction (n=59; 49.57%). The second twin was at significantly higher risk (p 0.05). Monochorionic twins had significantly high rates of stillbirths than dichorionic (p = 0.023). Most frequent maternal complications comprised pre-term labour (n=56; 47.05%), severe anaemia (n=22; 18.48%), hypertensive disorders (n=19; 15.96%) and postpartum haemorrhage (n=10; 8.40%).Conclusion: Twin pregnancies in women of low socioeconomic profile result in very high rates of low birthweight, pre-term births, intrauterine growth restriction, anaemia, hypertensive disorders and postpartum haemorrhage. Monochorionic pregnancies result in high rates of stillbirths and second twin is more likely to be compromised