Animesh Naskar, Anindita Sinha, Rup Kamal Das
BACKGROUND: Existing observations show that the second twin is at higher risk of morbidity and mortality compared to the first foetus because of obstetric complications that may occur after delivery of the first twin. A noticeable gap has been observed in statistical analysis of the same in Indian context. We wanted to analyse and establish the neonatal outcome between first and second twin.
METHODS: This is a prospective comparative study based on sample calculation based on 60 cases of twin pregnancies, 18-35 years of age, with more than 32 weeks of gestation where first twin was of cephalic presentation. Patients were in active labour and mode of delivery was vaginal. The key observation focuses on RDS development based on mother’s age, gravida, parity, gestation week, presentation, mode of delivery, sex, birth weight discrepancy, delivery interval, APGAR score, Down scoring, number of antenatal corticosteroid doses and ventilation requirement.
RESULTS: Results indicates that the delivery between 32-34 weeks causes RDS in first and second twin is 43% and 60%, respectively. In addition to this, sepsis development was observed in 16% and 22%, convulsions in 5% and 6% for first and second twin respectively. RDS development of second twin significantly depends on mother’s gravida (p = 0.038), number of antenatal corticosteroid doses (p = 0.044), and ventilation needed by the twins (p = 0.044).
CONCLUSIONS: RDS severity is more in second twin than the first twin. Completed dose of antenatal corticosteroid reduces the risk of RDS.