The Prevalence and the Outcome of Twin Pregnancies in a South-South Nigerian Tertiary Hospital

Abstract

Twinning is the commonest form of multiple pregnancy, and it is associated with increased adverse perinatal and maternal outcomes. A 5-year retrospective observational study of all cases of twin gestations delivered at the University of Uyo Teaching Hospital was conducted to determine the prevalence as well as document the maternal and perinatal outcomes associated with it. There were 219 twin deliveries during the study period, accounting for 2.17% of all deliveries. Twinning accounted for 98.65% of all multiple births during the period under review. The majority (62.1%) of the women were between 20 and 29 years of age, their mean age was 28.6 years, multiparous women (69.9%), mean parity was 2.7, and booked status (58.0%). The preterm delivery rate was 32.4%, the caesarean section rate was 42.9% and the perinatal mortality rate (PNMR) was 87 per 1000 births. Maternal complications included a high operative delivery rate of 42.8%, hypertensive disorders (9.6%), anaemia (2.7%) and 4.1% of postpartum haemorrhage. The perinatal morbidity and mortality and maternal morbidity rates were high. A significant percentage of the women with these high risk pregnancies were unbooked thereby reducing the opportunity for early detection and management in our environment. There is need for community education and advocacy on early booking and regular antenatal visits and better resources in our maternity unit to improve foetomaternal outcomes of twin.

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

“…10 According to their study the high twinning in the Igbo-Ora diet was due to ilasa (okra leaf) soup eaten with amala (yam or cassava flour) or the community's water which must be used for various purposes in addition to cooking to have the intended effect. 10, 17 Furthermore, this qualitative study, reported that the cause of dizygotic twinning may follow the eating of Amala & ilasa (okra leaves), influence by twin deity, physical residence in Igbo-Ora, eating of bananas, the care respect & the celebration of twins, eating of cassava flour, eating of fresh food, soil of Igbo Ora, use of Ilasa Water, eating of melon (egusi) leaves and eating of Yam. 10 Borokini et al in 2022 investigated the significance of the Okra plant leaf (Abelmoschus esculentus Moench L) in multiple births, and the Okra leaf included significant minerals and phytochemicals that perform biological protective effects against free radicals, thus alleviating oxidative stress.…”

“…was exactly the same rate in the recent past years of 2005 to 2011 in this study accounting for 21.7 per 1,000 of all deliveries. 17 …”

“…16 The twin prevalence figure reported by south-south geopolitical zone of Nigeria by Gabriel et al was exactly the same rate in the recent past years of 2005 to 2011 in this study accounting for 21.7 per 1,000 of all deliveries. 17 The varied durations of each study could potentially influence the divergence in prevalence rates across different studies. Another Igbo-Ora, a village in Oyo state, Southwest Nigeria, which is noted for having the highest frequency of twins in the world, showed a reduction in the twin birth rate from 45.1 per 1,000 deliveries in 1969 to a sharp decline of 27.2 per 1,000 in 1986.…”