Twin pregnancies in the Niger Delta of Nigeria: a four-year review

BACKGROUND: The female is programmed to nurture one fetus and to take care of one neonate at a time; hence, twin pregnancy is associated with an increased risk of preterm deliveries, perinatal morbidity, and mortality and maternal complications. This study aimed to determine the twinning rate, and maternal and fetal outcomes of all twin pregnancies managed at the Niger Delta University Teaching Hospital Okolobiri. METHODS: The study is a 4-year descriptive retrospective evaluation of twin pregnancies managed at the Niger Delta University Teaching Hospital Okolobiri. Records of all pregnancies, booked and unbooked, managed from January 1, 2007 to December 31, 2010 were reviewed. Details of delivery and maternal and fetal outcomes were obtained using a pro forma designed for the study. Epi Info version 3.5.3 was used for statistical analysis. The Chi-square test was used to test for associations between variables. The level of significance was set at P ≤ 0.05. RESULTS: A total of 1341 deliveries including 41 cases of twin deliveries were recorded during the study period, giving an incidence of 30.6/1000. Twenty-nine (70.7%) of the patients were unbooked. The mean gestational age was 33.3 ± 2.6 weeks, and the mean fetal weight was 2.34 ± 0.54 kg. There were 13 perinatal deaths, with a perinatal mortality rate of 158.5/1000. There was no association between booking status and perinatal mortality rate (χ(2) = 0.017, P = 1.000). Prematurity was the chief cause of perinatal death (65.4%). Maternal morbidities included anemia, wound infection, and genital sepsis. There were no maternal deaths. CONCLUSION: The twinning rate was high. There was a high perinatal mortality rate, with prematurity accounting for most of the mortality. There is a need for improved incubation/neonatal care for better outcomes with twin pregnancies in the hospital.