Prevalence, trend and outcome of twin pregnancy in Rivers State University Teaching Hospital, Southern Nigeria

Abstract

Background: Multiple pregnancy is a high-risk pregnancy associated with a higher maternal and perinatal complications compared to singleton pregnancy. Twinning is the commonest form of multiple pregnancy, and its prevalence varies across the globe, with lowest value in Japan and highest in Nigeria.Methods: The aim of the study was to review twin births in Rivers State University Teaching Hospital (RSUTH), to determine its prevalence, trend, and management outcome.Results: During the period under review, there were 13516, and 263 twin births, giving the prevalence of twinning in RSUTH as 19.5 per 1000 live births or 1 in 51 deliveries. The rate of twinning increased from 7.6 per 1000 deliveries in 2015 to 35.7 per 1000 deliveries in 2019. Mean age of patients was 31 SD 4.82 years, 95% CI: 30.42, 31.59, and modal age group was 30-34 years. Patients’ parity ranged from 0 to 7 with modal parity being para-1. Majority (51.7%) had secondary level education, and were Christians. Preterm delivery rate was 62.4%. The mean gestational age at delivery was 35.7 SD 2.9 weeks, 95% CI: 35.3, 36.0. The mean birth weights of the first and second twins were 2.39 SD 0.67 and 2.30 SD 0.69 respectively. Majority (92%) of the foetuses were alive at birth. Still birth and perinatal mortality rate were 4.2 and 7.8 per 1000 live births. There was no case of maternal mortality.Conclusions: The rate of twining in our setting is high, with an increasing trend. Most of the parturient had preterm delivery, and improved perinatal care services would ensure best perinatal outcome.

Audit on the first obstetric ultrasound in a tertiary health facility in the Niger Delta and its implications for maternal foetal care

“…Appropriately performed obstetric ultrasonography has been shown to accurately determine gestational age. 34 35 So if it is not done accurately the above itemised obstetric care will not be achieved.…”

“…23,24 It is recommended that CRL measurement should be used to determine gestational age unless it is above 84 mm; after this stage, Head circumference (HC) can be used, as it becomes slightly more precise than is BPD. 19,21,35 Unfortunately, in Nigeria the conduct of first obstetric ultrasound is saddled with diverse differences and it is not clear when it is normally done. At very early gestations, when the foetus is relatively small, measurement errors will have a more significant effect on gestational age assessment; the optimal time for assessment appears, therefore, to be somewhere between 8 and 13+6 weeks.…”

Trends and Outcomes of Twin Births in Southwest Nigeria: A 14-Year Retrospective Cohort Study

“…It forms an intriguing aspect of ethnobotany and merits further exploration in understanding the nuances of twin pregnancies. 7,8 Twin deliveries in the Yoruba population had higher mean follicle-stimulating hormone levels than singletons. 9 It has been hypothesized that certain plants in western Nigeria contain hormonelike compounds that raise follicle-stimulating hormone levels and, as a result, boost the population's rate of dizygotic twinning.…”

“…It forms an intriguing aspect of ethnobotany and merits further exploration in understanding the nuances of twin pregnancies. 7 , 8 …”