Prospective and comparative study of perinatal outcomes among monochorionic and dichorionic twins at tertiary care centre at GMC Aurangabad

Abstract

Objective :- The aim of this study was to evaluate chorionicity in twin pregancies and its impact on perinatal outcomes

Design :- This is a prospective observational study

Setting:- This studywas conducted in Department of Neonatology in Government Medical College Chhatrapati Sambhaji Nagar, a tertiary care public hospital for a period of 18 months, between January2024 to July 2025

Participants :- 251 mothers with DCDA and 114 mothers with uncomplicated MCDA twins were enrolled and followed till discharge including those admitted in NICU.Chorionicity was confirmed at delivery by examination of placenta and membranes

Main Outcome Measures :- Monochorionic twins have higher perinatal morbidity and mortality than dichorionic twins

Results:- In our hospital, 365 patients presented with multiple pregnancy. The incidence of twin pregnancy in our study was 1.42%. Mean maternal age of patients in our study was 25.3 years. With respect to chorionicity, 68.77% of women were dichorionic, 30.09% were monochorionic diamniotic and 0.54% patients were monochorionic monoamniotic. There was no maternal mortality in our study. In our study 10.68% of patients conceived following ovulation induction, IUI or IVF. In our cohort, significant association between low birth weight and chorionicity was established. The most common cause for neonatal intensive care admission was prematurity in both dichorionic 303/410 (73.90%) and monochorionic twins, 189/208 (90.86%) babies. Respiratory distress syndrome was more common among monochorionic babies (41.82% vs 26.83%). Neonatal deaths occurred in 50/502 (9.96%) babies of dichorionic babies, while in 29/228 (13.94%) monochorionic babies died. Perinatal mortality rate is 17.10% in monochorionic twins and 11.55% in dichorionic twins.

Conclusions:- MC twins are at more risk to develop various complications. Chorionicity should be determined on ultrasound in all twins preferably in first trimester.

Early diagnosis of twin pregnancy and proper follow up throughout pregnancy improves perinatal outcome.