Multiple Pregnancy and its Maternal Complications among Deliveries attending Nangarhar Univesity Teaching Hospital, Jalalabad, Afghanistan
##plugins.themes.academic_pro.article.main##
Abstract
Multiple pregnancies are associated with an increased risk of obstetric complications as well as perinatal morbidity and mortality in developing countries because of the increased risk to both mother and baby. Therefore, the current study aimed to identify the maternal complications of multiple pregnancies among deliveries at Nangarhar University Teaching Hospital, Jalalabad, Afghanistan. A descriptive cross-sectional study was conducted on 442 mothers who gave multiple births at Nangarhar University Teaching Hospital, Jalalabad, Afghanistan, from March 2022 to September 2023 after obtaining ethical approval from the Institutional Review Committee (reference number: 10/02-15-2022). A non-probability-convenient sampling technique was used to select study participants. Data were collected using questionnaires from the hospital-based medical records of all participants. Those patients who were admitted to the obstetrics and gynecology ward for delivery with a clinical or ultrasound-confirmed diagnosis of multiple pregnancies after examination were included. The data were analyzed using the Statistical Package for Social Sciences (SPSS) version 26. A total of 22,409 births were recorded during this study at Nangarhar University Teaching Hospital; 442 were twin pregnancies, with a prevalence of 19/1000 births. The mean age of the study participants was 28.6 ± 5.3 years, while the mean age of gestation at the presentation was 36.5 ± 2 weeks. Among these, 425 (96.2%) births were twins, and 15 (3.4%) were triplets. The seven leading maternal complications of multiple pregnancies were postpartum hemorrhage (14.7%), preterm delivery (12.7%), preeclampsia (10.4%), antepartum hemorrhage (5.9%), urinary tract infection (5.9%), polyhydramnios (4.1%), and anemia (32.4%). The most common route of delivery was normal vaginal (78.5%). Multiple pregnancies are associated with a high risk of maternal complications, particularly postpartum hemorrhage, preterm labor, and preeclampsia; thus, maternal risks can be reduced by receiving adequate prenatal and postnatal care and early detection of maternal complications. Mothers carrying multiple pregnancies should receive immediate counseling regarding all the complications and should be kept under constant monitoring.
Keywords
Maternal Complications, Multiple Pregnancy, Singleton Pregnancy, Twin Pregnancy##plugins.themes.academic_pro.article.details##
References
- Aziz, A., & Mulhim, A. (2001). Epidemiology and antenatal complicaitons of twin gestation: an 8-year review.
- Bangal, V. B., Patel, S. M., & Khairnar, D. N. (2012). Study of maternal and fetal outcome in twin gestation at tertiary care teaching hospital. International Journal of Biomedical and Advance Research, 3(10), 758-762.
- Beyene, M., Abdo Komicha, M., Hussien, H., Abdulwahed, A., Hassen, T. A., & Roba, K. T. (2022). Perinatal outcome of twin pregnancies among mothers who gave birth in Adama Hospital Medical College, Central Ethiopia. PLoS One, 17(9), e0275307.
- Bhattacharya, S., & Campbell, D. (2012). O104 Chorionicity and zygosity of twin pregnancies: association with maternal and perinatal complications. International Journal of Gynecology & Obstetrics, 119, S297-S297.
- Chauhan, S. P., Scardo, J. A., Hayes, E., Abuhamad, A. Z., & Berghella, V. (2010). Twins: prevalence, problems, and preterm births. American Journal of Obstetrics and Gynecology, 203(4), 305-315.
- Chowdhury, S., & Hussain, M. (2011). Maternal complications in twin pregnancies. Mymensingh medical journal: MMJ, 20(1), 83-87.
- Clinic, C. (2023). Multiple Birth. Retrieved from https://my.clevelandclinic.org/health/articles/9710-expecting-twins-or-triplets
- Deepthi, H., Pradeep, M., & Lalitha, S. (2015). Retrospective study of maternal and perinatal outcome of twin pregnancy in a teaching hospital. J Dental Med Sci, 14(1), 29-32.
- Doris, M. (1990). Multiple pregnancy. Baillieres Clin Obstet Gynaecol, 4, 109-127.
- Dubey, S., Mehra, R., Goel, P., Rani, J., & Satodiya, M. (2018). Maternal complications in twin pregnancy; recent trends: a study at a tertiary care referral institute in Northern India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 7(9), 3753-3758.
- Fell, D. B., & Joseph, K. (2012). Temporal trends in the frequency of twins and higher-order multiple births in Canada and the United States. BMC pregnancy and childbirth, 12, 1-7.
- Hamilton, B. E., Martin, J. A., & Sutton, P. D. (2004). Births: preliminary data for 2003. National vital statistics reports, 53(9), 1-17.
- Hibberd, L., Burlingham, M., Denton, J., Turville, N., Bagness, C., & Bailey, E. (2022). RCN multiple births midwife standard: review of distribution and implementation.
- Jayaraj, L., & Remani, P. (2023). Outcome in multifetal pregnancy-A cohort study. Indian Journal of Obstetrics and Gynecology Research, 7(4), 504-508.
- Laine, K., Murzakanova, G., Sole, K. B., Pay, A. D., Heradstveit, S., & Räisänen, S. (2019). Prevalence and risk of pre-eclampsia and gestational hypertension in twin pregnancies: a population-based register study. BMJ open, 9(7), e029908.
- Lam, F., Bergauer, N. K., Jacques, D., Coleman, S. K., & Stanziano, G. J. (2001). Clinical and cost-effectiveness of continuous subcutaneous terbutaline versus oral tocolytics for treatment of recurrent preterm labor in twin gestations. Journal of Perinatology, 21(7), 444-450.
- Lee, Y.-j., Kim, M.-N., Kim, Y.-M., Sung, J.-H., Choi, S.-J., Oh, S.-y., . . . Kim, J.-H. (2019). Perinatal outcome of twin pregnancies according to maternal age. Obstetrics & gynecology science, 62(2), 93-102.
- Malik, N. N. (2014). Frequency of common maternal complications in third trimester of twin pregnancy. Journal of Postgraduate Medical Institute, 28(4).
- Murray, S., & Norman, J. (2014). Multiple pregnancies following assisted reproductive technologies–a happy consequence or double trouble? Paper presented at the Seminars in Fetal and Neonatal Medicine.
- Rissanen, A.-R. S., Jernman, R. M., Gissler, M., Nupponen, I., & Nuutila, M. E. (2019). Maternal complications in twin pregnancies in Finland during 1987–2014: a retrospective study. BMC pregnancy and childbirth, 19(1), 1-7.
- Shetty, M. B., Shivananjaiah, C., & Swarup, A. (2016). A retrospective study: twin gestation at tertiary care, maternal and fetal outcome. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 5(1), 217-220.
- Tilahun, T., Araya, F., & Tura, G. (2015). Perinatal complications of twin deliveries at Jimma University specialized hospital, Southwest Ethiopia: a facility-based cohort study. Science, Technology and Arts Research Journal, 4(1), 134-138.
- Wen, S. W., Miao, Q., Taljaard, M., Lougheed, J., Gaudet, L., Davies, M., . . . Sprague, A. E. (2020). Associations of assisted reproductive technology and twin pregnancy with risk of congenital heart defects. JAMA pediatrics, 174(5), 446-454.