Background: Multiple pregnancy poses definite risks not only to the mother, but also to the fetuses. Despite improvement in obstetric and neonatal care, risk to the new born remains at least 3 times more than that of singletons. The main contributor to the increased incidence of perinatal mortality and morbidity in twins is prematurity. It is therefore not surprising that the increase in neonatal death in twins is proportionately greater than fetal death.  Other problems are fetal mal presentations and the complication of shared fetal circulation in monizygotic twins.

Objectives: To determine the perinatal mortality of twin pregnancies

Materials and Methods: This is a descriptive study conducted in SUT Medical college Vattappara and SRMC Medical college for a period of one year.  200 cases of twin pregnancies beyond 28 weeks of gestation admitted during this period was included in the study group.  Pregnancies with more than 2 fetuses were excluded from the study. The perinatal outcome of the babies were analyzed based on the gestational age, birth weight, Apgar scores at birth, NICU admission, still births, intrauterine deaths and neonatal deaths.

Results: Perinatal mortality in twin pregnancy in the present series is 11% and this was 3 to 4 times higher than that of singleton pregnancy.

Conclusion: Despite advances in Obstetrics and Gynaecology, the perinatal mortality of twins still remains high, three to four times higher than that of singleton.  There is clearly a direct relationship between the morbidity and mortality of multiple gestations and the significantly high rate of preterm deliveries, as well as increased incidence of small for gestational age babies associated with these pregnancies.

Keywords: Twin pregnancy, Perinatal mortality, Prematurity.