Multiple pregnancies are associated with increased maternal and neonatal complications. The present study aims to understand the maternal and perinatal outcomes of multiple pregnancies delivering at a tertiary care hospital of Northern India. The observational study was conducted in the department of obstetrics and gynecology, Sardar Patel Medical College and Hospital, Bikaner over a period of six months (Feb 2018 to August 2018).  It included all women admitted in antenatal ward and labor room with clinical or ultrasound diagnosis of twin pregnancy after 28 weeks of gestation. The incidence of twins in this study was 0.89%. Twins were seen more in multigravidas(53.17%) as compared to primigravidas (46.83%). Preterm labour (79.74%) and anemia (74.68%) were the commonest obstetric complications, whereas hypertensive disorders (16.45%) and PPH (13.92%) were other common complications in twin pregnancies. The rate of caesarean section was 40.50%. There were 36 perinatal deaths. Extreme prematurity and very low birth weight mainly contributed to Perinatal mortality

Respiratory distress, neonatal sepsis and DIC were the common causes of neonatal deaths. Early diagnosis of twin gestation with its chorionicity, regular antenatal checkups, early diagnosis and management of obstetrical complications, good diet, cervical encerclage in selective cases, maternal gluco-corticoids therapy in preterm labour, short term tocolysis, institutional delivery and better neonatal care facilities at hospital can improve the maternal and perinatal outcome in twin pregnancy.

Keywords: Twin pregnancy, Preterm labour, Perinatal outcome.

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