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Retained second twin: experience from Ile-Ife, Nigeria
O C Ezechi1, O B Fasubaa, B E K Kalu
1Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State Nigeria.
East African Medical Journal
|September 20, 2005
Summary
Retained second twin delivery poses significant risks, with high incidence and mortality rates. Prompt intervention and specialized care in equipped facilities are crucial for improving outcomes in twin pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Maternal-Fetal Medicine
Background:
- Retained second twin delivery is a major cause of perinatal and maternal morbidity and mortality.
- Intervention to save the retained fetus often leads to complications for both mother and infant.
Purpose of the Study:
- To review the incidence, management, and outcomes of retained second twin pregnancies.
- To identify factors contributing to complications and propose solutions for improved care.
Main Methods:
- Retrospective review of cases managed over a 12-year period (1988-1999).
- Study conducted at Obafemi Awolowo University Teaching Hospital, Ile Ife, Nigeria.
- Analysis of causes, referral patterns, and maternal/fetal complications.
Main Results:
- High incidence of retained second twin (7.9%).
- Majority of patients referred from rural centers with fetuses in poor condition.
- Fetal survival rate of 74.2% for those presenting within two hours.
- Significant perinatal (47.3%) and maternal (3.9%) mortality rates.
Conclusions:
- The incidence and complications of retained second twin remain high.
- Twin deliveries require management in well-equipped institutions with adequate staffing.
- An efficient referral system is essential for managing emergencies from peripheral centers.