TO STUDY THE DIFFERENT COMPLICATIONS DURING ANTEPARTUM, INTRAPARTUM AND POSTPARTUM PERIODS WITH POSSIBLE MEASURES TO MANAGE TWIN PREGNANCY

Background: The present study of twins was done among the patients admitted in the department of Obstetrics and Gynecology at Sri Aurobindo Medical College and Post Graduate Institute, Indore. Method: Blood sample from the mother was collected for estimation of hemoglobin percentage to diagnose anemia, ABO & Rh typing for blood transfusion if necessary. Urine examination for albumin, sugar & acetone. Special investigations like USG done whenever possible. In maximum cases ultrasonography was done to detect or confirm presence of twins, their lie, maturity, gestational age, rule out congenital anomaly & to note any IUGR, Discordant growth. Amount of liquor also noted. Result: 143 (85.10%) babies were LBW. The main factors responsible for LBW were IUGR and prematurity. Intrauterine growth retardation affected 42 cases (24.41%) while prematurity affected 42 cases (24.41%) and 8 (9.3%) cases aborted. Intrauterine death was more common in first baby, because of malpresentations. Asphyxia was found to be slightly more in second baby in our study. Congenital anomalies were found in total 3 cases (1.78%).  In one case, baby-2 was Anencephalic and in the other case baby-2 had fetal ascites.  In one case baby-1 had multiple congenital anomalies with imperforate anus. Cord prolapse was present in one case. In one case (Case No. 17) first baby was presented by footling with cord prolapse LSCS was done, baby had SBA and died 1 day after birth. There were 8 abortions. All were second trimester abortions (12 weeks and 22 weeks). Conclusion: In the present study, incidence of various antepartum and intrapartum complications were less in booked cases, which shows that availability of antenatal care to more patients will further reduce their incidence and thus will decrease maternal morbidity. Keywords: Complications, Antepartum, Intrapartum & Postpartum.