Background: Twin birth is considered a high-risk obstetrical situation. Despite the progress in obstetrical and pediatric care that has occurred in recent years, twin delivery is still associated with high maternal mo...Background: Twin birth is considered a high-risk obstetrical situation. Despite the progress in obstetrical and pediatric care that has occurred in recent years, twin delivery is still associated with high maternal morbidity and perinatal mortality. Few recent studies have focused on the complications and risk factors associated with complications of twin birth in our environment. The objective of our study was to identify the complications of twin birth and the factors associated with them. Methodology: We carried out a cross-sectional analytical study. Data collection was prospective, over a period of 4 months (January 1, 2022 to April 30, 2022), at the maternity units of the Gyneco-Obstetric and Pediatric Hospital of Yaoundé and the Central Hospital of Yaoundé. The study population included all pregnant women who gave birth to twins during our study period at these hospitals. Data analysis was done using the SPSS software (Statistical Package for the Social Sciences) version 23.0. The Chi-square test was used to compare proportions and the student’s t test to compare means. A p-value of less than 0.05 was considered statistically significant. Results: In total, we recorded 37 complicated twin deliveries out of a total of 66 twin deliveries. This corresponded to a complication rate of 56%. Maternal complications occurred in 11.38% of cases, the majority being soft tissue lesions (4.54%), and postpartum hemorrhage (4.54%). Perinatal complications at the time of delivery were dominated by early neonatal infections (12.12%), non-reassuring fetal condition (10.6%) and intrauterine fetal death (6.06%). Factors associated with complications of twin births after univariate analysis were: maternal age ≤ 30 years (OR = 8.15;CI = 9.78 - 71.06;P = 0.03), being a student, (OR = 5.09;CI = 3.65 - 7.10;P = 0.00), primary level of education (OR = 1.48;CI = 3.30 - 6.63;P = 0.00), having less than four prenatal contacts (OR = 5.76;CI = 12.2 - 27, 24;P = 0.02), lack of ultrasound assessments (OR = 2.65;CI = 1.08 - 4.65, P = 0.04), diagnosis of twinning at labor (P = 0.03), admission for preeclampsia and eclampsia (OR = 2.01;CI = 1.24 - 5.9;P = 0.04), qualification of birth attendant as midwife (OR = 2.33;CI = 6, 38 - 8.50;P = 0.00), delivery time greater than 15 minutes for the second twin (OR = 2.45;CI = 1.14 - 5.26;P = 0.019). Conclusion: twin birth remains associated with high maternal and neonatal morbidity in our environment. The rate of maternal-fetal complications is 56% in our series. Post-partum hemorrhage, soft tissue injury and early neonatal infections are the main complications. These are closely linked to a number of factors whose control would improve the prognosis of twin birth.展开更多
文摘Background: Twin birth is considered a high-risk obstetrical situation. Despite the progress in obstetrical and pediatric care that has occurred in recent years, twin delivery is still associated with high maternal morbidity and perinatal mortality. Few recent studies have focused on the complications and risk factors associated with complications of twin birth in our environment. The objective of our study was to identify the complications of twin birth and the factors associated with them. Methodology: We carried out a cross-sectional analytical study. Data collection was prospective, over a period of 4 months (January 1, 2022 to April 30, 2022), at the maternity units of the Gyneco-Obstetric and Pediatric Hospital of Yaoundé and the Central Hospital of Yaoundé. The study population included all pregnant women who gave birth to twins during our study period at these hospitals. Data analysis was done using the SPSS software (Statistical Package for the Social Sciences) version 23.0. The Chi-square test was used to compare proportions and the student’s t test to compare means. A p-value of less than 0.05 was considered statistically significant. Results: In total, we recorded 37 complicated twin deliveries out of a total of 66 twin deliveries. This corresponded to a complication rate of 56%. Maternal complications occurred in 11.38% of cases, the majority being soft tissue lesions (4.54%), and postpartum hemorrhage (4.54%). Perinatal complications at the time of delivery were dominated by early neonatal infections (12.12%), non-reassuring fetal condition (10.6%) and intrauterine fetal death (6.06%). Factors associated with complications of twin births after univariate analysis were: maternal age ≤ 30 years (OR = 8.15;CI = 9.78 - 71.06;P = 0.03), being a student, (OR = 5.09;CI = 3.65 - 7.10;P = 0.00), primary level of education (OR = 1.48;CI = 3.30 - 6.63;P = 0.00), having less than four prenatal contacts (OR = 5.76;CI = 12.2 - 27, 24;P = 0.02), lack of ultrasound assessments (OR = 2.65;CI = 1.08 - 4.65, P = 0.04), diagnosis of twinning at labor (P = 0.03), admission for preeclampsia and eclampsia (OR = 2.01;CI = 1.24 - 5.9;P = 0.04), qualification of birth attendant as midwife (OR = 2.33;CI = 6, 38 - 8.50;P = 0.00), delivery time greater than 15 minutes for the second twin (OR = 2.45;CI = 1.14 - 5.26;P = 0.019). Conclusion: twin birth remains associated with high maternal and neonatal morbidity in our environment. The rate of maternal-fetal complications is 56% in our series. Post-partum hemorrhage, soft tissue injury and early neonatal infections are the main complications. These are closely linked to a number of factors whose control would improve the prognosis of twin birth.
