A review of twin deliveries in Aminu Kano Teaching Hospital, North‑West Nigeria

Background: Twin pregnancy remains a high risk one, and its incidence varies from one ethnic group to the other. Twin delivery is also associated with increased neonatal and maternal morbidity and mortality. Objective: To det ermine the current incidence and document the complication of twin pregnancy in Kano, northwest Nigeria. Materials and Methods: A retrospective analysis of 231 cases of twin deliveries between 1st January 2007 to 31st December 2009, in Aminu Kano Teaching Hospital (AKTH) Kano was carried out. Results: During this study period, there were 15,233 deliveries and 353 cases of twin deliveries, giving an incidence of 2.3% or 1 in 43 deliveries. The mean maternal age and parity were 29.0 years and 2.6 respectively. The mean gestational age at delivery was 36.9 weeks, with a mean birth weight of 2.4 kg and 2.3 kg for the first and second twin respectively. Male twins constituted 50.3% of twin births. The commonest presentation of twins was Cephalic-cephalic in 52.2%. This was followed by breech‑cephalic in 29.6%, cephalic‑breech in 12.6% and breech‑ breech in 5.2%. Mode of delivery was vaginal in 57.4% while 40.0% delivered by Caesarean section. The commonest indication for the Caesarean section was due to breech presentation in the leading twin (75.0%). Hypertensive disorder in pregnancy was the commonest maternal complication accounting for 63.16%, increasing maternal morbidity and mortality, while prematurity was the leading cause of perinatal mortality. Conclusion: This study has shown that the incidence of twin pregnancy is high in Aminu Kano Teaching Hospital, Kano, northwest of Nigeria. It has also shown that twin delivery is associated with prematurity, malpresentations and operative delivery, therefore increased perinatal and maternal morbidity. It is therefore recommended that twin pregnancy should be supervised in a tertiary centre under a specialist care and where facility for neonatal support is available to improve its outcome and reduce perinatal morbidity and mortality.