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Retained second twins in Enugu, Nigeria
U U Aniebue1, H U Ezegwui, B C Ozumba
1Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
Summary
Retained second twin, occurring in 1 in 6 deliveries, significantly increases perinatal mortality. Malpresentation and uterine atony are key causes, necessitating improved interventions for better outcomes.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Maternal-Fetal Medicine
Background:
- Twin deliveries present unique obstetric challenges.
- Retained second twin is a significant complication impacting perinatal outcomes.
- Understanding the incidence and causes of retained second twin is crucial for improving care.
Purpose of the Study:
- To review the experience with retained second twin (RST) in Enugu, Nigeria.
- To analyze the incidence, causes, and perinatal outcomes associated with RST.
- To identify factors influencing perinatal mortality in cases of RST.
Main Methods:
- Retrospective analysis of twin delivery records from January 1991 to December 2000.
- Definition of retained second twin: delay of 30 minutes after first twin delivery.
- Data collection included delivery details, maternal factors, and perinatal outcomes.
Main Results:
- Retained second twin occurred in 1/6 twin deliveries.
- Perinatal mortality rate for RST was 288.5 per 1000 deliveries, 1.7 times that of the first twin.
- Principal causes included malpresentation (54%) and uterine atony (39%).
Conclusions:
- Retained second twin is a preventable condition with significant perinatal risks.
- Early intervention with vacuum extraction or cesarean delivery is advocated.
- Effective health education and supervision of primary healthcare facilities are essential to reduce RST incidence and mortality.