A Comparative Study of Perinatal Outcome in Monochorionic and Dichorionic Twin Pregnancies

Shazia Anwar; Aalia Jadaan; Saima Anwar; Mohsana Saeed Zia

Shazia Anwar Assistant professor of Obstetrics & Gynecology, Aziz Fatimah Medical and Dental College and Hospital, Faisalabad.
Aalia Jadaan Associate professor of Obstetrics & Gynecology, Aziz Fatimah Medical and Dental College and Hospital, Faislabad.
Saima Anwar Senior Registrar, Obstetrics & Gynecology, Unit I, Holy family Hospital. Rawalpindi
Mohsana Saeed Zia Assistant Professor, Azad Jammu & Kashmir Medical College Muzaffarabad

Keywords: Twin Pregnancy, Monochoromic, Dichorionic, High-risk pregnancy

Abstract

Objective: To compare perinatal outcome in monochorionic and dichorionic twins pregnancies in our setup.

Methodology: This retrospective Cohort study was conducted in the department of Obstetrics and gynaecology, Aziz Fatima Teaching hospital, Faisalabad. All the data of twin pregnancies delivered during last two years from January 2019 to December 2020 was included. Twin fetuses delivered after 20 weeks of gestation in study period were selected. Fetal data was analyzed based on chorionicity of the placenta. Three groups were defined based upon chorionicity and amniotic sac as Diamniotic dichorionic (DADC), Diamniotic Monochorionic (DAMC), and Monoamniotic Monochorionic (MAMC). Information regarding different fetal parameters and on gross congenital malformations were recorded.

Results: There was no significant difference (p-value > 0.05) in mean age among all three groups. The rate of gestational diabetes mellitus (13.9%) was significantly (p-value < 0.05) higher in DAMC twin pregnancies. The mean gestational age was noted lowest (34.21 Â± 2.8) in MAMC group followed by (34.6 Â± 3.1) in DAMC and (35.2 Â± 2.4) in DADC group. The mean birth weight was significantly (P-value < 0.05) lesser (1.62 Â± 0.56 kg) in MAMC and (1.86 Â± 0.52 kg) in DAMC as compared to (1.99 Â± 0.41 kg) DADC group. The rate of discordant twins â‰¥ 25% was found significantly (P-value < 0.05) higher (25%) in MAMC pregnancies. Rate of live birth was highest (96.3%) in DADC and lowest (75%) in MAMC group.

Conclusions: Twin pregnancies become challenging for the obstetrician due to higher risk of morbidity and mortality and this risk further increases with monochorionic twin pregnancies. So, the chorionicity should be screened as early as possible for proper management.