Perinatal Outcome of the Second Twin at a Tertiary Care Center in India.
This cross-sectional observational study was undertaken to assess perinatal outcome of the second twin in respect to gestational age, presentation, mode of delivery, and birth weight.



Seventy women with confirmed twin pregnancy were admitted and managed in a tertiary care teaching hospital in Kolkata, India from May 2008 to April 2009. All relevant data were recorded and analyzed statistically by simple proportions andχ2test.



Women with frequent antenatal visits had highly favorable perinatal outcome than those with fewer or no visits in this hospital (p< 0.001). Higher perinatal mortality was observed among preterm than term (p< 0.01) cases, and among low birth weight than normal babies (p< 0.05). Second twins in vertex-vertex presentation encountered higher perinatal mortality compared to those in vertex-nonvertex and nonvertex-other presentations (p< 0.05). Perinatal outcome was unfavorable when both delivered vaginally than for both cesarean deliveries and cesarean after first vaginal delivery (p< 0.01). Preterm labor was the most frequently observed maternal complication. Birth asphyxia and perinatal mortality were common among second than first twins.



Gestational age, presentation, mode of delivery, and birth weight are the significant determinants of perinatal outcome of the second twin. Women with frequent antenatal care show favorable outcome. The second twin is at higher risk of perinatal morbidity and mortality than the first twin.
Department of Obstetrics and Gynecology, Calcutta National Medical College and Hospital, Kolkata, West Bengal India.
Hiralal
H
Konar
Department of Community Medicine, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu India ; 221 Central Avenue, DAE Township, Kalpakkam, 603 102 Tamil Nadu India.
Madhutandra
M
Sarkar
Department of Obstetrics and Gynecology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal India.
Joydip
J
Paul
Birth weight; Gestational age; Perinatal mortality; Second twin; Twin pregnancy