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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  and
S.S. Ratnam
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.

Keywords

Twin pregnancyPerinatal mortalityEarly diagnosisIncidence of twinning
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 33 , Issue 1 , January 1984 , pp. 27 - 33
Copyright
Copyright © The International Society for Twin Studies 1984

References

REFERENCES

1.Baird, SD (1961): Public health aspects of low birthweight. WHO Tech Rep Ser No 217.Google Scholar
2.Brettes, JP, Renaud, R, Gantar, R (1976): A double-blind investigation into the effects of ritodrine on uterine blood flow during the third trimester of pregnancy. Am J Obstet Gynecol 124:164.Google Scholar
3.Dawood, MY, Ratnam, SS, Lim, YC (1975): Twin pregnancy in Singapore. Aust NZ J Obstet Gynaecol 15:93.Google Scholar
4.Drillien, CM (1964): The Growth and Development of the Prematurely Born Infant. Edinburgh: E and S Livingstone.Google Scholar
5.Goldberg, R, Joffe, BI, Bersohn, I, Van Os, M, Krut, L, Seftel, HC (1975): Metabolic responses to selective B adrenergic therapy. S Afr Postgraduate J 51:53.CrossRefGoogle Scholar
6.Guttmacher, (1939): Twin Pregnancy in North America. Am J Obstet Gynaecol 38:277.Google Scholar
7.Jeffrey, RL, Bowes, WA, Delaney, JJ (1974): Role of bed rest in twin gestation. Obstet Gynaecol 43:822.Google Scholar
8.Jouppila, P (1975): Twin pregnancy. Acta Obstet Gynecol Scand Suppl 44:13.CrossRefGoogle ScholarPubMed
9.Morris, N, Osborn, SB, Wright, HP (1955): Effective circulation of the uterine wall in late pregnancy. Lancet 1:313.Google Scholar
10.Pederson, MI (1974): In: Studies on Carbohydrate Metabolism in Newborn Infants of Diabetic Mothers, p 48Copenhagen.Google Scholar
11.Szabo, AJ, Szabo, O (1974): Placental free-fatty-acid transfer and fetal adiposity on infants of diabetic mothers. Lancet 2:498.CrossRefGoogle ScholarPubMed
12.TambyRaja, RL, Atputharajah, V, Salmon, Y (1978): Prevention of prematurity in twins. Aust NZ J Obstet Gynaecol 18:179.Google Scholar
13.TambyRaja, RL, Ratnam, SS (1981): Plasma steroid changes in twin pregnancy. In Gedda, L, Parisi, P, Nance, WE (eds): Twin Research 3: Part A, Twin Biology and Multiple Pregnancy. New York: AR Liss, p 199–202.Google Scholar
14.TambyRaja, RL, Ratnam, SS (1981): Health benefits of appropriate timing, spacing and avoiding high parity and risks of unplanned fertility for the mother. In: Proceedings of the International Association for Maternal and Neonatal Health, Manila, Philippines.Google Scholar
15.TambyRaja, RL, Ratnam, SS (1982): The small fetus: growth-retarded and preterm. Clinics in Obstetrics and Gynaecology, Vol 9 No 3, 517.CrossRefGoogle ScholarPubMed
16.Wynn, V, Oakley, NW (1978): Feto-placental unit in diabetic pregnancy. Proceedings of the 6th Asia Oceania Congress of Endocrinology.Google Scholar