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Kavitha Kothapally1*, Uma Bhashyakarla2, Tilak Chandrapal3
1, 2Dept. of Obstetrics & Gynaecology, Bhaskar Medical College & General Hospital, Yenkapally, Moinabad, Rangareddy–500075, AP, India.
3Dept. of Paediatrics, Bhaskar Medical College & General Hospital, Yenkapally, Moinabad, Rangareddy–500075, AP, India.


Article history
Received: 16 December 2013
Revised: 26 December 2013
Accepted: 29 December 2013
Early view: 30 December 2013

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Spontaneous multifetal pregnancies
Mode of delivery.


Background: The present study was done at Bhaskar General Hospital, a teaching hospital located in a rural area in AP. The aim of the study was to analyze the occurrence of spontaneous twinning among the rural pregnant women attending this hospital.
Subject and Methods: The study was conducted from January 2011 to December 2013. The study showed the incidence of spontaneous twinning as 1.3 per cent of births at our hospital.
Results: A total of 40 cases of spontaneous twins were noted over 3 year observation periods. More than 80% were multigravidae & 20% were primigravidae. 5% had treatment for infertility. 12.5% had family history of twins. 80% were in the age group of 21-30 yrs. 80% were dichorionic diamniotic twins. Most of them could be delivered after 34 wks with live fetuses weighing more than 2 kg birth weights with minimal complications of mother & child.
Conclusion: Incidence of spontaneous twinning was 3.8% in the studied population. Most of the pregnant women in the study population did not have any etiology. Negligible number had twinning after treatment for infertility. With adequate bed rest, early hospitalization at 32-34 weeks with careful monitoring by NST & USG, nearly all patients could continue their pregnancies beyond 36 weeks of gestation. Regarding mode of delivery, the guidelines are based on presentation, fetal weight & fetal well being. Well known complications included abortion, hyperemesis, anemia, PIH, IUGR, preterm labour, PROM. Others are malpresentations, abnormal lie, polyhydramnios, PPH, retained II twin & increased operative vaginal delivery.