OUTCOME OF TWIN DELIVERIES IN A UNIVERSITY HOSPITAL OF SOUTH-WEST NIGERIA

OUTCOME OF TWIN DELIVERIES

Abstract

Background: The rising rate of twin deliveries is a considerable cause of public health concern due to higher risks of maternal and perinatal morbidity as well as mortality. Periodic reviews of twin births are thus essential in achieving satisfactory outcomes. This study set out to determine the incidence and pregnancy outcome of twin deliveries in a University Hospital.

Methodology: A retrospective review of medical records of women delivered of twins was conducted over a four-year period. Maternal obstetric profile, neonatal characteristics and perinatal outcome were assessed and analysed with SPSS version 20.0 software.

Results: Of the 19,139 deliveries, 388 were twins (twining rate=20.27/1000 births) but only 369 had complete data. Mean maternal age was 30.4 ± 4.8years; 165(44.7%) had vaginal deliveries; seven (1.9%) of which had combined vaginal and caesarean delivery. Caesarean delivery occurred in 204 (55.3%) cases and hypertensive disorder was the leading indication (40.7%). Unbooked women and those with antenatal complications had higher risks of Caesarean delivery (p = 0.013, p < 0.0001). Preterm delivery occurred in 58.5% and the mean gestational age was 36.6 ± 2.4weeks. Mean birth weights of the first and second twins were 2.5 ± 0.53kg and 2.4 ± 0.54kg respectively. There were 714 live births and 24 stillbirths (stillbirth rate=3.4%). Though 53.5% and 49.6% of leading and second twins respectively had no need for resuscitation, second twins delivered by Caesarean section recorded more excellent Apgar scores when compared to those delivered vaginally (p = 0 .002). Fifty eight women (15.7%) experienced postpartum haemorrhage but no maternal death was recorded.

Conclusion: The period incidence of twin delivery was modest in our study site. Delivery occurred predominantly by Caesarean section and neonatal outcome was average. Women with twin gestations should be encouraged to patronize institutions with specialized obstetric services as better outcome exists in a setting of good antenatal, intra and post-partum care.