Pregnancy Impact Of Chorionity On Gestational Outcome In Twin Pregnancies

Objective: To observe the incidence of twin pregnancy and analyze the impact of chorionic of twin pregnancy on pregnancy complications and perinatal outcome.Methods: A retrospective study was conducted to collect twin pregnant women delivered in the First Affiliated Hospital of Xinjiang Medical University from January 1,2015 to December 31,2017,and to observe the incidence of twin pregnancy year by year.According to the chorionic properties,they were divided into single chorionic(MC)twin group and double chorionic(DC)twin group.The general information and adverse maternal and fetal outcomes were compared between MC and DC group to analyze the influence of chorion properties on pregnancy outcomes.Results: 1)in 2015-2017 years,the incidence of double pregnancy was 5.5%,increasing year by year.2)Among 156 pregnant women,118(75.6%)had double chorioamniotic membrane,29(18.6%)had single chorionic membrane and 9(5.8%)had single chorionic membrane.3)The incidence of adverse outcomes in this study was 30.1% for Pregnancy-induced Hypertension,24.4% for gestational diabetes mellitus,9.6% for intrahepatic cholestasis of pregnancy,10.9% for Preterm premature rupture of membranes,10.3% for postpartum hemorrhage,0.6% for polyhydramnios;80.8% for preterm labor,71.8% for low birth weight,16.7% for intrauterine fetal growth restriction,14.1% for neonatal asphyxia,and 6.9% for twin to twin transfusion syndrome,3.2% for single intrauterine fetal demise,1.3% for fetal distress.4)There was no significant difference in age,education level and pregnancy between MC twin group and DC twin group(P > 0.05);there was significant difference in pregnancy mode,delivery mode,scar uterus between MC twin group and DC twin group(P < 0.05).5)The incidence of pregnancy-induced hypertension in DC twin group was higher than that in MC twin group,and the difference was statistically significant(P < 0.05);the incidence of complications such as gestational diabetes mellitus,intrahepatic cholestasis of pregnancy,Preterm premature rupture of membranes,postpartum hemorrhage and polyhydramnios had no statistical significance between the two groups(P > 0.05).6)The incidence of low birth weight,premature delivery,intrauterine fetal growth restriction,i single intrauterine fetal demise and fetal asphyxia in MC twin group were significantly higher than those in DC twin group(P < 0.05),but the incidence of fetal distress and neonatal asphyxia had no significant difference between the two groups(P > 0.05).Conclusion: Twin chorionicity may be associated with pregnancy complications such as gestational hypertension,premature delivery,and low birth weight of the newborn,intrauterine fetal death,intrauterine fetal growth restriction and adverse perinatal outcomes.Therefore,early diagnosis of chorionicity,strengthen pregnancy monitoring,early detection and treatment of pregnancy complications and perinatal neonatal outcomes.