Retained second twin: experience from from Ile-Ife, Nigeria

Abstract

Background: Retained second twin contributes significantly to perinatal morbidity and mortality, as well as maternal morbidity and mortality, usually arising as a result of intervention to salvage the retained foetus. Objective: To review the current incidence, management, fate and outcome of both the retained foetus and its mother, with a view to proffering solution. Design: Retrospective review over a 12 year period from January 1988 to December 1999. Setting: Obafemi Awolowo University teaching hospital, Ile Ife, Nigeria. Subjects: All cases of retained second twin managed during this period. Main outcome measures: Causes, sources of referral, perinatal and maternal complications. Results: The incidence is still high (7.9%). Majority of the patients were referred from rural centers (49.6%) and in poor fetal conditions (41.9%). The fetal survival in patients that presented within two hours of delivery of the first twin was 74.2%. The perinatal and maternal mortality were 47.3% and 3.9% respectively. Conclusion: The incidence and associated maternal and fetal complications of retained twin is still rather high. Therefore, irrespective of the antenatal course and early labour findings, the conduct of twin deliveries must be in a well-equipped health institution with adequate staff. There should also be an efficient referral system for occasional emergencies from the peripheral centres.

Perinatal Outcome of the Second Twin

“…With regard to stillbirths two second twins and one first twin had inter-delivery interval of <30 minutes. Similar to this finding, in study done by Ezechi et al, 27 neonatal death were higher than still birth rates in retained second twin (47.3 % vs. 41.9%).…”

Review of Twin Pregnancies in a Tertiary Hospital in Abuja, Nigeria

“…The number of retained second babies noted in this study was lower than 16.3% reported in Enugu ( 22 ). It is, however, higher than 7.9% in Ife ( 23 ). The high incidence noted may be attributable to the large number of unbooked cases in this study.…”