TWIN BIRTHS IN SOKOTO: A 5-YEAR REVIEW
Shehu C. E.* and Sulaiman B.
Background: Twin pregnancy is of major obstetric importance in Nigeria, not just because the highest incidence in the world occurs here but it also poses higher feto-maternal risks in our low-resource setting due to scarcity of human and material resources which translates to increased maternal/perinatal morbidity and mortality. Objectives: To determine the incidence, mode of delivery, and factors associated with maternal and perinatal morbidity and mortality in twins delivered at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Methodology: All case notes of twin deliveries from 1st January 2009 to 31st December 2013 were retrospectively reviewed. Data obtained were analysed using SPSS for windows version 20.0. Results: There were 15,712 deliveries of which 187 were twin births giving an incidence of 11.9 per 1,000 births. The mean maternal age was 27.9 ± 5.7 years with a mean parity of 2.9 ± 2.8. The mean gestational age at delivery was 33.1 ± 6.6 weeks. Majority, 135 (72.2%) were delivered vaginally while 41(21.9%) had Caesarean delivery. The remaining 11(5.9%) had combined vaginal/Caesarean deliveries. Malpresentation 11 (29.7%) was the most common indication for caesarean section. Hypertensive disorders of pregnancy 37 (20.1%) and low birth weight 97 (26.3%) were the leading maternal and fetal complications. The stillbirth rate was 57.1 per 1000 births. There was no maternal mortality. Conclusion: The incidence of twin pregnancy is relatively low in our centre. Vaginal delivery was the most common mode of delivery and fetal malpresentation necessitated delivery by caesarean section. The most common maternal morbidity was hypertensive disorders in pregnancy and low birth weight was the most common fetal complication. There was no maternal death. Further regular audits are recommended to monitor practice.
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