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Factors Contributing to a Reduction of Twin Perinatal Mortality in Singapore

Published online by Cambridge University Press:  01 August 2014

R.L. TambyRaja*
Affiliation:
Department of Obstetrics and Gynaecology, National University of Singapore, Kandang Kerbau Hospital, Singapore
S.S. Ratnam
Affiliation:
Department of Obstetrics and Gynaecology, National University of Singapore, Kandang Kerbau Hospital, Singapore
*
Dept. of Obstetrics and Gynaecology, Kandang Kerbau Hospital, Hampshire Road, Singapore, 0821

Abstract

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A total of 204 cases of twin pregnancy occurred between 1970 and 1972 have been compared with 102 cases occurred between 1976 and 1978. During the interval of time, specialised care was instituted for the early diagnosis and management of twins. The incidence of twin pregnancy in Singapore decreased from 1:131 to 1:141 pregnancies. With a background of improved socioeconomic conditions and obstetric care, there has been a dramatic decline in perinatal mortality from 76.4 to 29 per 1000. In undiagnosed cases, the perinatal mortality of the first vs the second twin in the earlier group was 64.4 vs 93.6 per 1000. No such difference was observed in the later period, with the average birthweights of twins being significantly higher. The principles of our antenatal supervision, antenatal tocography, and management are presented and the value of early diagnosis, bedrest, and tocolytic therapy discussed. The reduced perinatal mortality and mobidity gives evidence of an improvement in prematurity and augmented intrauterine growth.

Type
Research Article
Copyright
Copyright © The International Society for Twin Studies 1984

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