A year of multiple pregnancy in Lancashire

Multiple pregnancy has increased in incidence over the last thirty years. They currently account for 3% of all live births, largely due to assisted conception techniques. The incidence in 2009 was 16 per 1000 women compared with 10 per 1000 in 1980.1 The Lancashire Women and Newborn Centre was created as part of a merger within East Lancashire NHS Trust in November 2010. Part of the amalgamation of services involved the creation of a dedicated multiple pregnancy clinic. This has made it easier to improve care in this group. Objective We looked at the service a year later, focussing on mode of delivery and outcome. Method The search was performed using our electronic maternity database, Athena (K2MS). Results 100 of our 6500 deliveries over the twelve month time period were cases of multiple pregnancy. Two were triplets, 30 were monochorionic twins and the rest were dichorionic twins. 66 had a Caesarean section. 7 were Grade 1, 23 were 2A/2B and 13 were grade 3. 23 were elective Caesarean. From the 34 who had a vaginal delivery, 5 had forceps, 7 had ventouse and 17 of the deliveries involved vaginal breech deliveries, all except one being the second twin. One case was a double breech delivery. Conclusion By capturing this population through the multiple pregnancy clinic, we are able to analyse our local data and thus counsel our patients accurately regarding gestation, complications and outcomes in multiple pregnancy.