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

Abstract

Studies on twin pregnancy are uniquely important to Africa and particularly Nigeria where the highest incidence in the world exists. This study was designed to determine the trend, rate, and obstetric outcomes of twin deliveries in the University of Abuja Teaching Hospital, Gwagwalada. This was a retrospective study of twin deliveries in the hospital over a period of 10 years. During the study period, there were 349 twin births out of 10,739 deliveries, giving an overall twining rate of 32.5 per 1,000 deliveries. Preterm delivery occurred in 39.7% cases and was, therefore, the most common complication. Mode of delivery was vaginal in 72.7% while 27.3% were delivered by caesarean section. Emergency caesarean section for delivery of both the babies was carried out in 22.3% while elective caesarean section for both the babies accounted for 1.0 %. Combined vaginal and abdominal delivery occurred in 4.0% of deliveries. The stillbirth rate was 102 per 1,000 births. There were 24 (8.0%) and 37 (12.3%) stillbirths among the first and the second baby respectively. The mean foetal weight was 2.395±0.63 kg while the female-to-male ratio was 1:1.1. The rate of twin deliveries in our centre is high. Successful vaginal delivery of twins is high when the mothers are booked and the presentations of the twins are favourable. The use of antenatal care services and good intrapartum management will help improve outcome in twin pregnancies.

Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries

“…17 First, early detection of twin pregnancies, good antenatal care tailored towards the needs of mothers pregnant with twins, and timely referral for hospital delivery are important preconditions for twin survival and maternal health during and after delivery. 5,35,36 However, still too few women pregnant with twins in the region receive appropriate medical care. 5,37 For example, almost half of the women giving birth to twins in a Nigerian tertiary hospital did not receive antenatal care 35 and of the mothers who delivered twins in a study hospital in Guinea Bissau, as many as 65% were not aware that they were pregnant with twins.…”

“…5,35,36 However, still too few women pregnant with twins in the region receive appropriate medical care. 5,37 For example, almost half of the women giving birth to twins in a Nigerian tertiary hospital did not receive antenatal care 35 and of the mothers who delivered twins in a study hospital in Guinea Bissau, as many as 65% were not aware that they were pregnant with twins. 5 A first recommendation therefore is to strengthen antenatal care services and train providers of this care in recognising twin pregnancies.…”

“…18,19,36 Second, it is important that delivery should take place in a hospital setting with staff trained in twin deliveries and with facilities for interventions, including caesarean section. 5,35 Twins are a high-risk group, associated with preterm delivery and complications such as post-partum haemorrhage and increased maternal mortality. [2][3][4]35 Twin deliveries have a substantially increased risk of caesarean section.…”

“…5,35 Twins are a high-risk group, associated with preterm delivery and complications such as post-partum haemorrhage and increased maternal mortality. [2][3][4]35 Twin deliveries have a substantially increased risk of caesarean section. 2 In our data for the 2009-14 period, the crude under-5 mortality rate for twins was 178·2 per 1000 among deliveries that took place in a medical setting compared with 250·9 per 1000 among deliveries at home.…”

“…2 In our data for the 2009-14 period, the crude under-5 mortality rate for twins was 178·2 per 1000 among deliveries that took place in a medical setting compared with 250·9 per 1000 among deliveries at home. Given that almost half of these twin births took place without assistance of a medically trained person, and that many hospital deliveries in sub-Saharan Africa are last minute or emergency cases, 5,35 there is still much to gain.…”