Background: Multiple pregnancy constitutes an important portion of high risk pregnancies and is a matter of grave concern to obstetricians and paediatricians owing to maternal and perinatal morbidity and mortality associated to it. Objective of present study was to evaluate maternal and perinatal outcome of twin pregnancy.Methods: This observational study included 50 women with twin pregnancy with gestational age of 26 weeks or more. Maternal and perinatal outcomes were studied.Results: The incidence of twin pregnancy was 2.8 % with maximum incidence in age group of 20 -29 years and in multigravida. Mean gestational age was 34.2 weeks. Vertex - vertex fetal presentation was most common presentation. Most frequent mode of delivery was ceserean section (54%). Preterm labour was most common maternal complication (74%), followed by anaemia (62%). Complications in perinatal period were birth hypoxia (58 %), intrauterine growth restriction (15 %), hyper-bilirubinemia (11%) and neonatal sepsis (10 %). 88% of the newborns were LBW. Perinatal mortality in our study was 17%.Conclusions: Twin pregnancies are associated with significant maternal and perinatal morbidity which is more so for second twin. Effective antenatal care planned delivery and good pediatric facilities help decrease the complications. Managment of twin pregnancy requires multidisciplinary approach and involvement of skilled obstetricians and paediatricians.

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The obese first degree relatives of type 2 diabetics are more prone to develop diabetes mellitus in later life. Having one parent with type 2 diabetes mellitus carries 1.6 fold and both the parents with type 2 diabetes mellitus (T2DM) has 3.2 fold higher risk of developing T2DM. Lipid accumulation product (LAP) is a simple and reliable index of central lipid accumulation. It combines waist circumference and triacyglycerols. Studies have revealed that LAP is a better indicator than Body mass index (BMI) in predicting risk of diabetes mellitus and metabolic syndrome. Weight gain and body mass are the main factors in increasing risk for diabetes mellitus. Fat cells produce chemicals (inflammatory markers) that cause inflammation. Internal inflammation can also leads to the development of diabetes mellitus. C-reactive protein (CRP) is an inflammatory marker produced by liver cells. Studies have shown that elevated CRP is linked to higher risk of developing diabetes in later life. In this study, we have found an association of Serum Insulin (SI), LAP and CRP in first degree relatives of type-2 diabetics. We had taken 100 Obese first degree relatives of type-2 diabetics as subjects and 100 age and sex matched first degree relative of T2DM without obesity were taken as controls. Fasting blood glucose, Fasting TGs estimations were done using fully autoanalyser. Waist circumference (in cm) was measured and also LAP score was calculated by using the formula, i.e. (WC-58)*TG mmol/l & (WC-65)*TG mmol/l in females and males respectively. CRP was estimated using Nyco-card reader. Serum Insulin was measured using ELISA reader. The Mean ±SD of Serum Insulin, CRP, LAP, FBS in Group I were found to be 15.9±2.54, 6.05±1.5mg%, 106.8±40.7, 133.0±18.9 mg% respectively compared to Group II 9.2±1.28, 2.59±1.2, 25.7±14.6, 78.7±8.2. A highly significant correlation of LAP and CRP (p<0.01) was found in study group. A significant correlation of Serum Insulin (SI), CRP and LAP score (p<0.5) was found. This study suggested that first degree relatives of type-2 diabetics should have some modification in their lifestyle as they are at increased risk of metabolic syndrome, diabetes and coronary artery disease.

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