Background: Multifetal gestation is associated with increased maternal and neonatal complications. With the rise of assisted reproductive technologies (ART), the incidence of such pregnancies has increased.
Objective: To evaluate the maternal and neonatal outcomes in multifetal pregnancies and assess the associated complications and mortality at a tertiary care center in Jorhat, Assam.
Methods: A prospective observational study was conducted from March 2023 to February 2024 at Jorhat Medical College and Hospital. Fifty women with multifetal gestation ≥28 weeks were enrolled. Data on demographic factors, antenatal care, complications, mode of delivery, and neonatal outcomes were collected and analyzed.
Results: Out of 4744 births, 50 were multifetal gestations (49 twins, 1 triplet), giving an incidence of 1.05%. Majority (62%) were aged 21–29 years and unbooked (80%). Primigravidas accounted for 62%. ART was the cause in 12%, and 58% delivered between 29–36 weeks. Most were dichorionic-diamniotic (64%). Maternal complications included anemia (62%), preterm labor (58%), hypertensive disorders (14%), PPROM (14%), PROM (12%), APH (6%), and PPH (22%). Cesarean section rate was 62%, most commonly for malpresentation. Perinatal mortality was 8.1%. There was no maternal mortality.
Conclusion: Multifetal pregnancies are associated with increased maternal and neonatal morbidity. Early diagnosis, regular antenatal care, and adequate neonatal support can significantly improve outcomes.

Keywords: Multifetal pregnancy, maternal outcome, neonatal outcome, twin pregnancy, high-risk pregnancy