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[Perinatal and maternal risks in multiple pregnancies].

A Picaud1, R Nlome-Nze, N Ogowet-Igumu

  • 1Département de Gynécologie-Obstétrique, Centre Hospitalier Universitaire, Libreville, Gabon.

Revue Francaise De Gynecologie Et D'Obstetrique
|May 1, 1989
PubMed
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Perinatal mortality in twin pregnancies is significantly higher due to prematurity and intra-uterine hypoxia. Early diagnosis and specialized care are crucial for improving outcomes in multiple births.

Area of Science:

  • Obstetrics and Gynecology
  • Perinatology
  • Public Health

Context:

  • Multiple pregnancies, particularly twin gestations, present elevated perinatal risks within Gabonese cultural contexts.
  • Perinatal mortality in twins is four times higher than in singleton pregnancies, with prematurity being the primary cause.
  • Maternal complications include hypertensive disorders and severe anemia, tripling maternal mortality risk.

Purpose:

  • To analyze perinatal mortality in twin pregnancies in Gabon.
  • To identify key etiological factors contributing to fetal and maternal mortality.
  • To propose strategies for improving perinatal outcomes in multiple gestations.

Summary:

  • Prematurity (30% before 32 weeks) and intra-uterine hypoxia are major contributors to fetal demise, with the second twin and prolonged birth intervals increasing risk.

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  • Fetal prognosis is linked to birth weight, with risks escalating beyond 2,500g.
  • Maternal mortality is primarily associated with delivery hemorrhages.

    • Impact:

    • Early ultrasonographic diagnosis and enhanced pregnancy monitoring are recommended.
    • Integrated social support, prenatal testing, and hospital delivery by specialized teams can improve prognosis.
    • Cesarean section is not considered a primary factor for enhancing fetal survival in twin births.