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Fetal outcome of twin gestations in a Nigerian teaching hospital.

BACKGROUND
Although twin gestation is associated with increased perinatal morbidity and mortality, optimal management of this high risk pregnancy is associated with improved outcome for the mother and her baby. Globally, Nigeria has the highest incidence of twinning. This makes studies on twin gestation important, especially on the outcome of the babies which is reflection of the type of care received during the antenatal and intrapartum period.


STUDY OBJECTIVE
This study was designed to determine the fetal outcomes of twin deliveries in a tertiary hospital in Nigeria's Federal Capital Territory.


METHOD
This was a retrospective study of babies following twin pregnancies delivered in the hospital from 1st January 1998 to 31st December 2007.


RESULTS
Out of the 600 babies reviewed, 10.2% were still births giving a still birth rate of 102 per 1000 births. Majority of the stillbirths (73.8%) occurred amongst the unbooked mothers and was higher amongst the second twins. More of the booked mothers had their babies delivered at term compared to the unbooked ones, 115 (38.3%) Vs 66 (22.0%).There was a statistically significant association between gestational age at delivery and booking status of the paturients. (X2 = 16.257, P = 0.001). The mean fetal weight was 2.395 kg +/- 0.63. There was no statistically significant difference when the weights of the first and second twin were compared. (t = 0.343, P = 0.732). Out of the 539 babies born alive, 85.0% had good Apgar score of = 7 in5 minutes, 13.0% of the first twins had moderate birth asphyxia compared to 16.0% of the second twins. The female to male ratio was 1:1.1.


CONCLUSION
Twin gestation is associated with low birth weights and high still birth rate in this centre. Fetal outcome is better in the first twin compared to the second twin. Outcome for babies whose mothers were booked were better compared to the unbooked. Quality antenatal care and intrapartum management will help improve fetal outcome.