Volume : 7, Issue : 9, September - 2018

A COMPARATIVE STUDY OF PERINATAL OUTCOME OF SECOND BABY VERSUS FIRST BABY IN TWIN DELIVERY

Dr. Ruchi N. Thakur, Dr. Seema C. Kshirsagar

Abstract :

<p class="MsoNormal"><b style="mso-bidi-font-weight:normal"><span lang="EN-GB" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">TYPE OF PRESENTATION</span></b><span lang="EN-GB" style="font-size:12.0pt;line-height:&#10;115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">: Original article<b style="mso-bidi-font-weight:normal"><o:p></o:p></b></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><b style="mso-bidi-font-weight:normal"><span lang="EN-GB" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">TITLE OF THE PAPER</span></b><span lang="EN-GB" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">:<b style="mso-bidi-font-weight:normal">&ldquo;A COMPARATIVE STUDY OF PERINATAL OUTCOME OF SECOND BABY VERSUS FIRST BABY IN TWIN DELIVERY&rdquo;</b><o:p></o:p></span></p> <p class="MsoNormal"><b style="mso-bidi-font-weight:normal"><span lang="EN-GB" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">AUTHERS</span></b><span lang="EN-GB" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">:Dr. Thakur Ruchi,<u><span style="color:black;mso-themecolor:text1">Dr.Kshirsagar Seema</span></u><o:p></o:p></span></p> <p class="MsoNormal"><b style="mso-bidi-font-weight:normal"><span lang="EN-GB" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">NAMEOFINSTITUTE</span></b><span lang="EN-GB" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">:Department of Obstetrics and Gynaecology ,B.J.G.M.C. and Sassoon General Hospital,Pune-41101<o:p></o:p></span></p> <p class="MsoNormal"><b style="mso-bidi-font-weight:normal"><span lang="EN-GB" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">INTRODUCTION</span></b><span lang="EN-GB" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">:Twin pregnancy is becoming a problem of increasing dimensions worldwide with the dramatic increase in its incidence mostly attributable to assisted reproductive technologies (ARTs).<sup>1</sup>Its incidence varies worldwide. <span style="color:black"><o:p></o:p></span></span></p> <p class="MsoNormal" style="margin-top:6.0pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:0in;margin-bottom:.0001pt;text-align:justify;text-justify:inter-ideograph;&#10;line-height:200%"><b style="mso-bidi-font-weight:normal"><span lang="EN-GB" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;color:black">OBJECTIVE</span></b><span lang="EN-GB" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;color:black">: </span><span lang="EN-GB" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">To study the perinatal outcome of second twin during labour as against the first twin.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.0pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:22.5pt;margin-bottom:.0001pt;text-align:justify;text-justify:inter-ideograph;&#10;text-indent:-22.5pt;line-height:200%"><span lang="EN-GB" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">1<span style="mso-spacerun:yes">&nbsp; </span>.To determine the effect of malpresentations, effect of mode of delivery on perinatal outcome of second twin, i.e. twin B.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.0pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:22.5pt;margin-bottom:.0001pt;text-align:justify;text-justify:inter-ideograph;&#10;text-indent:-22.5pt;line-height:200%"><span lang="EN-GB" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">2. To study the effect of maternal status, antenatal, intranatal complications, time interval between the delivery of two babies and its relation to the perinatal outcome of second twin.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.0pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:22.5pt;margin-bottom:.0001pt;text-align:justify;text-justify:inter-ideograph;&#10;text-indent:-22.5pt;line-height:200%"><span lang="EN-GB" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">3<span style="mso-spacerun:yes">&nbsp;&nbsp; </span>To compare APGAR at 1 and 5 minutes of both the babies.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.0pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:22.5pt;margin-bottom:.0001pt;text-align:justify;text-justify:inter-ideograph;&#10;text-indent:-22.5pt;line-height:200%"><span lang="EN-GB" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">4.<span style="mso-spacerun:yes">&nbsp; </span>To compare differences in birth weights in both the twins with relation to perinatal deaths.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.0pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:22.5pt;margin-bottom:.0001pt;text-align:justify;text-justify:inter-ideograph;&#10;text-indent:-22.5pt;line-height:200%"><span lang="EN-GB" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">5.<span style="mso-spacerun:yes">&nbsp; </span>To observe the conventional management and to find out the suitable management for the delivery of second baby.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.0pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:22.5pt;margin-bottom:.0001pt;text-align:justify;text-justify:inter-ideograph;&#10;text-indent:-22.5pt;line-height:200%"><span lang="EN-GB" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">6.<span style="mso-tab-count:1">&nbsp;&nbsp;&nbsp;&nbsp; </span>To find out the incidence of perinatal mortality of twins.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.0pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:0in;margin-bottom:.0001pt;text-align:justify;text-justify:inter-ideograph;&#10;line-height:200%"><b style="mso-bidi-font-weight:normal"><span lang="EN-GB" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">MATERIAL AND METHODS:</span></b><span lang="EN-GB" style="font-size:12.0pt;line-height:&#10;200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"><o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.0pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:0in;margin-bottom:.0001pt;text-align:justify;text-justify:inter-ideograph;&#10;line-height:200%"><span lang="EN-GB" style="font-size:12.0pt;line-height:200%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">A prospective analytical study was undertaken with a view to analyze the vulnerability i.e. perinatal outcome of second twin during labour as against the first twin.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.0pt;text-align:justify;text-justify:&#10;inter-ideograph;line-height:200%"><b style="mso-bidi-font-weight:normal"><span lang="EN-GB" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;color:black">RESULTS</span></b><span lang="EN-GB" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;color:black">: <o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.0pt;text-align:justify;text-justify:&#10;inter-ideograph;line-height:200%"><span lang="EN-GB" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">The study findings emphasize the importance of appropriate management protocols directed towards counseling, frequent and regular antenatal check-ups, early admission of mothers, and proper care during intrapartum and immediate postpartum periods. Second twins should be managed more carefully during intranatal and early neonatal periods. Twin pregnancy can be effectively managed in a tertiary health care facility to optimize maternal and fetal care for improving perinatal outcome.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.0pt;text-align:justify;text-justify:&#10;inter-ideograph;text-indent:.5in;line-height:200%"><span lang="EN-GB" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Perinatal mortality of monochorionic twins is much higher than that of dichorionic twins. Antepartum diagnosis of the type of placentation will help in identifying the twins at risk for twin to twin transfusion syndrome, discordant growth and greater perinatal mortality. Good antenatal care, early diagnosis, recognition and treatment of antenatal risk factors, prevention of preterm labour and close fetal surveillance, particularly of monochorionic twins and prompt therapeutic intervention of TTTS are necessary to reduce perinatal mortality. Strict intrapartum monitoring, experienced obstetricians to conduct delivery, liberal use of LSCS along with good neonatal intensive care especially for premature babies, will lead to better outcome.<o:p></o:p></span></p>

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Cite This Article:

Dr.Ruchi N.Thakur, Dr.Seema C.Kshirsagar, A COMPARATIVE STUDY OF PERINATAL OUTCOME OF SECOND BABY VERSUS FIRST BABY IN TWIN DELIVERY, GLOBAL JOURNAL FOR RESEARCH ANALYSIS : Volume-7 | Issue-9 | September-2018


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