Birth weight discordance is the difference between the heaviest and the lightest fetus in a set of multiples. It is the most common aspect because some variation is expected among siblings. But growth discordance has been associated with adverse outcomes, mainly because it is associated with growth restriction. The specific cause is yet to be determined. Keeping these concepts as the background, in this study an attempt was made to determine the cause of discordance in twins and perinatal outcome of the discordant twins. This was a cross sectional study involving the pregnant women who were carrying twins. A thorough general examination and obstetric examination was carried out and ultrasonography was done. Discordance on ultrasonography, if present, was noted by estimating the fetal weights. The twins were considered to be discordant if the discordance was more than 15%. Discordance was categorized into mild if the discordance was between 15-25% and severe if the percentage of discordance was >25%. In the present study, a total of 210 cases of twin pregnancies were screened to identify the discordant twins. Out of them 70 cases were found to be with discordant twins and the incidence was found to be 33.3%. Among the 70 cases of discordant twins, 44 (63%) cases were found to be with mild discordance and 26 (37%) cases were observed to be with severe discordance. The main cause of the majority cases (97.1%) was observed to be with intra uterine growth restriction which is mainly due to placental insuffiency. In our study pre term delivery is the most common complication observed followed by pregnancy induced hypertension (PIH). In our study, the perinatal mortality was found to be 30.7%. Cesarean delivery gave a better perinatal outcome when compared to vaginal delivery. Perinatal mortality was found to be more common in monochorionic twins when compared with dichorionic twins. The perinatal mortality and morbidity is more for the second twin when compared with the first twin. It is the responsibility of the health care professionals to counsel the pregnant women carrying twins regarding growth discordance, the necessity and significance of regular antenatal visits, complications associated with discordant twins and the perinatal mortality and morbidity and increased financial burden.
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