Fetomaternal outcome of twin gestation in Port Harcourt, South-South, Nigeria.

BACKGROUND

Twin pregnancy is a high risk pregnancy with significant implications for both mother and baby. This study is to assess the current status of twin gestation in Port Harcourt in view of the rising incidence worldwide.

OBJECTIVE

To determine the prevalence, fetal and maternal outcomes of twin gestation at the University of Port Harcourt Teaching Hospital (UPTH).

MATERIALS AND

METHODS

This was a 5-year retrospective analysis of hospital records of mothers who had twin gestation and delivered at UPTH between January 1st 2008 and December 31st 2012.

RESULTS

The prevalence of twin gestation was 16 per 1000 deliveries. The Mean age and parity were 29.63 ± 4.1 and 1.65 ± 1.3 respetcively. Premature delivery occurred in 30.8% of cases. Antenatal complications were observed in 66.0% with anaemia being the commonest complication. Caesarean section was performed for 51.06% while 47.34% had successful vaginal delivery and discordant delivery accounted for 1.6%. The commonest intrapartum complication was fetal distress in 42.86%. There was no significant difference in the mean birthweight between first and second twin. Unbooked status was significantly associated with birth asphyxia (x2 = 8.25, p = 0.004) and perinatal mortality (x2 = 5.04, p = 0.02). Monochorionic placentation was also significantly associated with perinatal mortality (x2 = 5.52, p = 0.018). The perinatal mortality rate was 55.85/1000 total birth while the maternal mortality ratio was 281.09/100,000 live birth.

CONCLUSION

Twin gestation in Port Harcourt is still associated with significant maternal and perinatal morbidities and mortality. Early initiation of specialist care in the management of twin gestation and improvement in neonatal care facilities will improve the outcome of twin gestation in Port Harcourt.