Abstract Introduction: Twin gestation has always fascinated mankind throughout history. Twin pregnancy is one of interesting event occurring in human reproductive biology. Prematurity and low birth weight is the main causes of high perinatal morbidity and mortality in twins. They are also at higher risk having negative impact on long-term mental and physical health and tend to have significantly higher care costs. Considering all these factors, the management of twin pregnancies remains a challenge. Aims and objectives: To study the Maternal and perinatal outcomes associated with twin pregnancy. Materials and Method: The present study was conducted in the in post graduate Department of Obstetrics and Gynaecology of SMGS hospital, Government Medical Collage Jammu. Data was collected from November 2013 to octomber 2014. All women admitted to the labour room after clinical or ultrasound diagnosis of twin gestation were enrolled in the study. Women with less than 28 weeks of gestation were excluded. Women with preexisting medical disorder e.g. cardiac disorder, renal disorder, vasculopathies etc were also excluded. Thus total 195 mothers with twin pregnancies were enrolled during the study. Informed consent was obtained from all the cases. Data was collected on a predesigned semi structured proforma on which patient’s demographics data, risk factor for twin pregnancy, gestation, hemoglobin, mode of delivery, antepartum, intrapartum and postpartum complication comprising severe anemia, pregnancy-induced hypertension, pre-eclampsia, eclampisa, antepartum hemorrhage, maternal death, birth weight, Apgar score, neonatal intensive care admission (NICU), and perinatal outcome was recorded. Patients were followed up after one week of delivery to record early neonatal complication and deaths within the first 7 days. Results: Out of total 195 twin deliveries were studied and it was observed that 60% cases delivered vaginally whereas 39.49% cases delivered by caesarean section. Out of total cases delivered by caesarean deliveries 38.96% were elective and 61.03% were emergency. It was observed that 12.82% of cases had premature rupture of membranes. Preterm labour was observed in 41.03% of cases. Out of the total 390 deliveries (195 twin pregnancies) 91.09% were live births whereas 8.20% were still births. NICU admission was required in 29.23% newborns. Birth weight of <2.5 kg was seen in 61.03% of first twin and 73.33% of second twin. Apgar score of <7 was more commonly observed in twins with vaginal mode of delivery. Apgar score of <7 was observed in 12.82% of second delivered twin in comparison to 6.67% observed in first twin. Conclusion: Multiple pregnancies had higher likelihood of maternal and neonatal adverse outcome. Prematurity, low birth weight and perinatal death were the common adverse outcome associated with twin pregnancies.

Keywords: twin pregnancy, Preterm labour, low birth weight, still birth.