title: Outcome of Twin Deliveries at a Tertiary Care Centre of Eastern Nepal.
abstract: BACKGROUND
  Twins, compared to singletons, have higher perinatal mortality and morbidity. The aim of this study was to describe the twinning rate, epidemiological variables and hospital outcome of twin deliveries and to find out ways of better management of twins in our part.
  
  
  METHODS
  A retrospective evaluation of the outcome of 92 twin pregnancies during one year study period (1st January 2014 to 31st December 2014) was conducted at BPKIHS. Twins delivered within the institution were included but cases less than 28 weeks gestation were excluded. Maternal and neonatal data were retrieved and analysed.
  
  
  RESULTS
  The twinning rate was 9.2/1000 (92/10,031). The mean birth weight was 1636.30 ±339.21 grams and mean gestational age 34.31±2.67 weeks(28 - 40 weeks). One hundred eighty-two babies (98.9%) were low birth weight (LBW) while 32.1% were small for gestational age (SGA). There was mild, moderate and severe growth discordance in 63 (68.5%)22 (23.9%)and 7 (7.6%) respectively. Three (3.26%) of 92 pairs had twin-to-twin transfusion syndrome. The hospital mortality rate was 10.87% (20/184) and 69 (37.5%) babies had complications. The clinical causes of death were hyaline membrane disease in 7 (3.3%), severe birth asphyxia in 5 (2.7%), congenital malformations in 3(1.6%) and sepsis in 3 (1.6%) babies.
  
  
  CONCLUSIONS
  Twin deliveries are common in this hospital and have poor hospital outcome with more complications and mortality. Hence there is a need for further studies with long term follow-ups to plan for better management of twins in our part.
authors.affiliation: Department of Pediatrics and Adolescent Medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: S
authors.initials: S
authors.lastname: Chaudhary
authors.affiliation: Department of Pediatrics and Adolescent Medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: R R
authors.initials: RR
authors.lastname: Singh
authors.affiliation: Department of Pediatrics and Adolescent Medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: G S
authors.initials: GS
authors.lastname: Shah
authors.affiliation: Department of Pediatrics and Adolescent Medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: J
authors.initials: J
authors.lastname: Agrawal
authors.affiliation: Department of Pediatrics and Adolescent Medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: S
authors.initials: S
authors.lastname: Kafle
authors.affiliation: Department of Pediatrics and Adolescent Medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: L
authors.initials: L
authors.lastname: Shah
mesh_terms: D000328:Adult; D001724:Birth Weight; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D008297:Male; D008423:Maternal Age; D009390:Nepal / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D014427:Twins / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Low birth weight (LBW);preterm; small for gestational age (SGA);twins.