Abstract:
Background: Twin pregnancy is a high risk pregnancy with increased risk of obstetric
complications which have important implications on the Perinatal outcome. This situation is
worse in Sub-Saharan Africa due to lack of well-equipped facilities. However, studies on twin
pregnancy and its maternal and fetal outcomes are limited in Ethiopia. Thus, this study aimed to
fill this gap.
Objectives: The objective of the study was to determine the prevalence, and compare obstetric
complications of twin and singleton deliveries in Nekemte referral hospital from March 1/2016 -
February 30/2017 G.C.
Method: Hospital-based unmatched Case-control study design was carried-out on all mothers
delivered in obstetrics ward of Nekemte Referral Hospital from March 1, 2016 to February 30 ,
2017 after 28 completed weeks with their corresponding records and charts. The data was
collected through pretested structured check list and analyzed using SPSS version 20.0. First
descriptive statistics done then odds ratio along with their 95% confidence intervals were
determined to measure the existence of significant associations between twin delivery and each
maternal and fetal complication by using chi-squared (χ2) test, Fisher- Exact test was used when
the assumption of the χ2- test was not fulfilled.
Results: The incidence of twin deliveries were 28.6 in 1000 deliveries. Hypertensive disorder of
pregnancy(OR=2.1;95%CI=1.54,2.86), preterm labor(OR=2.76;95% CI=2.12,3.40),
prematureruptureofmembrane(OR=1.87;95%CI=1.28,2.73),antepartumhemorrhage(OR=1.80;95
%CI=1.09,2.99),cesareandelivery(OR=2.50;95%CI=1.88,3.34),anemia(OR=1.77;95%CI=1.24,2.
52),postpartumhemorrhage(OR=1.27;95%CI=0.77,2.11),sepsis(OR=2.18;95%CI=1.46,3.25),cor
dprolapse(OR=2.33;95%CI=1.51,3.84), and blood transfusion(OR=1.74;95%CI=0.90,3.38) were
ante partum, intrapartum and postpartum maternal complications of twin deliveries. Low
APGARscoreat1stminute(OR=1.75;95%CI=1.29,2.37),lowbirthweight(OR=3.36;95%CI=2.61,4.
31),neonatalinnsivecareunitadmission(OR=2.95;95%CI=2.25,3.89),andearlyneonataldeath(OR=2
.46;95%CI=1.81,3.34) were the major perinatal complications.
Conclusion: The prevalence of twin pregnancies in this study was high. The likelihood of
developing hypertensive disorder of pregnancy, preterm labor, premature rupture of membrane,
ante partum hemorrhage, cesarean delivery, cord prolapse, anemia, postpartum hemorrhage,
puerperal sepsis, blood transfusion, low Apgar score at 1st minute, low birth weight, neonatal
intensive care unit admission, and early neonatal death was significantly higher in twin deliveries
when compared with singleton deliveries. Therefore, greater emphasis should be given on the
area of adequate blood service, newborn resuscitation, and standard care for mothers with
premature rupture of membrane, to prevent maternal and perinatal complication related to twin
deliveries.