TITLE:
Outcomes of Twin Delivery at the Bamenda Health District, North West Region Cameroon
AUTHORS:
William Ako Takang, Dobgima Walters Pisoh, Tcheumbe Josiane Nyeumenou, Enow Robinson Mbu, Mary Bi Shu Atanga
KEYWORDS:
Outcomes, Twin, Singleton, Pregnancies, Deliveries, Bamenda, Health, District
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.12 No.5,
May
31,
2022
ABSTRACT: Introduction: Multiple gestations or multiple pregnancies occur
when two or more fetuses are conceived at the same time in the same woman.
Therefore, a twin pregnancy is defined as the simultaneous development of two
fetuses in the same woman. It can either be a monozygotic or dizygotic
pregnancy. Twin pregnancy is considered a high-risk pregnancy with variable
incidence and outcomes worldwide. The adverse maternal and fetal outcomes of
twin deliveries have not yet been investigated in our setting. Objectives: The main objective of this study was to
evaluate the outcomes of twin deliveries at the Bamenda Health District. Methods:
This was a hospital-based, cross-sectional analytic study done at the
Bamenda Health District in three selected hospitals (Bamenda Regional Hospital,
CMA Nkwen, and IHC Azire) from the 1st of January to the 10th of May 2018. 55 women with twin pregnancies and 55 women with singleton
pregnancies at gestational ages of 28 completed weeks and above who came for
delivery and who consented to the study were included. A face-to-face
interview-administered questionnaire was used to obtain sociodemographic
characteristics; a venous blood sample was collected from the mothers before
and after delivery to determine the estimated blood loss based on haemoglobin
level. The partogram was opened from 4 cm cervical dilatation for those who
came in the first stage of labour and the mode of delivery was recorded. After
delivery, outcome variables were 1st, 5th, and 10th min Apgar score, birth weight, and gestational age. Data were entered in CSPro
7.1 and exported to IBM SPSS version 23.0 for analysis. All variables with p
Results: During
the study period, we included 110 participants (55 twin mothers and 55
singleton mothers). Women with twin gestations were mostly aged between
25 and 34 years with a mean maternal age of 28.6 ± 5.8 years, more than half
(60%) of them were multiparous with family histories of twin, and business was their main occupation (58.2%). The
prevalence of twin gestations at the Bamenda Health District was 2.8%. As
compared to singleton deliveries, twin deliveries were associated with adverse
fetal outcomes such as prematurity (born before 37 completed weeks) which was
about 6 times higher among twins than singleton babies (OR: 5.6, 95% CI: 2.2 - 14.3,
p th min) that
was 15 times higher in twin than singleton births (OR: 15.3, 95% CI: 2 - 116.6, p grams) that was 15.6 times
increased in twin than singleton births (OR: 15.6, 95% CI: 3.6 - 67.8, p
CI: 2.2 - 13.9, p 0.05). Conclusion: Twin deliveries were associated
with adverse fetal outcomes (prematurity, birth asphyxia, and low birth weight)
in the three health facilities where we carried out the study. Cesarean section
was higher among women with twin gestations compared to women with singleton
gestations.