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RETAINED SECOND TWIN: EXPERIENCE FROM ILE-IFE, NIGERIA
Abstract
ABSTRACT
Background: Retained second twin contributes significantly to perinatal morbidity and
mortality, as well as maternal morbidity and mortality, usually arising as a result of
intervention to salvage the retained foetus.
Objective: To review the current incidence, management, fate and outcome of both the
retained foetus and its mother, with a view to proffering solution.
Design: Retrospective review over a 12 year period from January 1988 to December
1999.
Setting: Obafemi Awolowo University teaching hospital, Ile Ife, Nigeria.
Subjects: All cases of retained second twin managed during this period.
Main outcome measures: Causes, sources of referral, perinatal and maternal
complications.
Results: The incidence is still high (7.9%). Majority of the patients were referred from
rural centers (49.6%) and in poor fetal conditions (41.9%). The fetal survival in patients
that presented within two hours of delivery of the first twin was 74.2%. The perinatal
and maternal mortality were 47.3% and 3.9% respectively.
Conclusion: The incidence and associated maternal and fetal complications of
retained twin is still rather high. Therefore, irrespective of the antenatal course and
early labour findings, the conduct of twin deliveries must be in a well-equipped health
institution with adequate staff. There should also be an efficient referral system for
occasional emergencies from the peripheral centres.
Background: Retained second twin contributes significantly to perinatal morbidity and
mortality, as well as maternal morbidity and mortality, usually arising as a result of
intervention to salvage the retained foetus.
Objective: To review the current incidence, management, fate and outcome of both the
retained foetus and its mother, with a view to proffering solution.
Design: Retrospective review over a 12 year period from January 1988 to December
1999.
Setting: Obafemi Awolowo University teaching hospital, Ile Ife, Nigeria.
Subjects: All cases of retained second twin managed during this period.
Main outcome measures: Causes, sources of referral, perinatal and maternal
complications.
Results: The incidence is still high (7.9%). Majority of the patients were referred from
rural centers (49.6%) and in poor fetal conditions (41.9%). The fetal survival in patients
that presented within two hours of delivery of the first twin was 74.2%. The perinatal
and maternal mortality were 47.3% and 3.9% respectively.
Conclusion: The incidence and associated maternal and fetal complications of
retained twin is still rather high. Therefore, irrespective of the antenatal course and
early labour findings, the conduct of twin deliveries must be in a well-equipped health
institution with adequate staff. There should also be an efficient referral system for
occasional emergencies from the peripheral centres.
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