Retained second twins in Enugu, Nigeria.

OBJECTIVES

To review our experience with retained second twin in Enugu, Nigeria, over a 10-year period.

METHODS

The second twin is retained when a delay of 30 min occurs after the delivery of the first twin. The case notes and records of all twin deliveries at the University of Nigeria Teaching hospital Enugu between January 1991 and December 2000 were retrieved and analyzed.

RESULTS

Retained second twin occurred in 1/6 twin deliveries with a resultant perinatal mortality rate of 288.5 per 1000 deliveries which was 1.7 times that of first twin. Malpresentation (54%) and uterine atony (39%) were the principal causes of retained second twins. The place of delivery of the first twin, prolonged birth intervals, oxytocin augmentation of labor and breech extraction affected perinatal outcome.

CONCLUSIONS

Early recourse to vacuum extraction and cesarean deliveries of retained second twin, effective health education and adequate supervision of primary health care facilities are advocated to reduce this preventable condition.