Magnitude and obstetric complication of twin deliveries in Nekemte referral hospital, east wollega zone, ethiopia, 2017 g. C

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.