Lubna Noor, Sara Ali, Qudsia Nawaz.
Determination of Birth Outcomes Among Twins.
J Rawal Med Coll Jan ;19(1):53-6.

Background :To determine the birth outcomes among twins in terms of mean gestational age, birth weight and Apgar score. Methods: In this descriptive study twin pregnant women were selected among the women attending the antenatal clinic and emergency . Ultrasound for the determination of chorionicity (number of placentae i.e. either one or two placentae) of twins was performed. Cases were followed till the time of delivery . At the time of delivery birth outcomes i.e. gestational age , birth weights and Apgar scores at 1 and 5 minutes were noted on the study performa by attending obstetrician. Gestational age at the time of delivery was determined by last menstrual period or by ultrasound. Digital scale machine was used for determining birth weights in grams . Five parameters of Apgar scores, at 1 and 5 minutes, after birth were determined .These included A appearance, P pulse rate, G grimace, A activity, R respiratory effort. Each parameter was given a score of 0, 1 or 2. Results: Out of 3995 deliveries 58 women (1.4%) were diagnosed as having twins. Among the twins 46.55% were mono-chorionic (MC) and 53.44% were di-chorionic (DC).The mean maternal age among twins was 27.08+ 4.47 years with a range of 20 to 40 years . Among twins mostly were multigravida (67.2%).The mean gestational age among twins was 35.62 + 2.99 weeks, with a range of 27 to 41weeks.The mean birth weight of twins was 2019.31 + 486.50 with a range of 800 to 3000g.The mean birth weight of twin 1 was 2065.51 + 486.14 and that of twin 2 was 1973.10+486.67g.The mean Apgar score of twins at 1 min was 6.51 + 1.82 with a range 0.00 to 9.00 and it was at 5mins 7.84+ 1.95 with a range 0.00 to 10.00. The mean Apgar score of twin 1 at 1 and 5 min was 6.68+1.80 and 7.94+2.04 respectively. Whereas the mean Apgar score of twin 2 was 6.34+1.84 at 1min and it was 7.74+1.87 at 5min. Conclusion: Prematurity and low birth weight are the common complications of twins associated with low Apgar score. The mean birth weight and Apgar scores of twin 1 are more than twin 2.

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