Pregnancy Induced Hypertension in Twin Pregnancy
Apichart Chittacharoen MD*, Suwimon Wetchapruekpitak MD*, Somsak Suthutvoravut MD*
Affiliation : * Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hopital, Mahidol University
Objective : To compare the incidence, severity and pregnancy outcomes of pregnancy induced hypertension in
twins and singleton gestations.
Materials and Methods : The cohort study enrolled 305 twins and 298 singleton gestations at Department of
Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok,
Thailand between January 1996 and December 2001. The rates of pregnancy induced hypertension and
pregnancy outcomes were statistically analysed in both groups. P-value of < 0.05 was considered statistically
significant.
Results : Pregnancy induced hypertension was found to at develop 18.36% in the twin gestations, compared
with 5.03% in the singleton gestations (P<0.05). Women with twin gestations had higher rates of pregnancy
induced hypertension (RR 3.65, 95% CI 2.11-6.30, P<0.05) and occurred earlier than singleton gestations
(35.86±2.50 VS 37.40±1.18 weeks, P<0.05). Twin gestations with preganancy induced hypertension had
significantly higher rate of cesarean delivery, low birthweight, NICU admission and perinatal death than
singleton gestations with pregnancy induced hypertension (P<0.05). Moreover, the abruptio placenta,
postpartum hemorrhage and perinatal mortality in twin gestations with pregnancy induced hypertension
group were significantly higher than in normotensive group (P<0.05).
Conclusion : The incidence of pregnancy induced hypertension was significant higher and occurred earlier
with greater adverse pregnancy outcomes among twin gestations than singleton gestations. Moreover, the
rate of adverse maternal and perinatal outcomes in twin gestations with pregnancy induced hypertensive
group was higher than in normotensive group.
Keywords : Twin gestations, Pregnancy induced hypertension, Pregnancy outcomes
