Caesarean section in twin pregnancies in Enugu, Nigeria

Objective: To compare the rates, indications and complications of caesarean section in twin and singleton pregnancies. Methods: A retrospective comparative analysis of caesarean sections done for twin and singleton pregnancies at the University of Nigeria Teaching Hospital, Enugu, Nigeria, over a six-year period. Differences in variables between the two groups were compared by means of the t-test or chi-square test as appropriate at the 95% confidence level. Results: During the study period, 314 twin and 10753 singleton deliveries were conducted in the hospital. The caesarean section rate (36.6%) for twins was significantly higher than the rate (21.9%) for singletons (p = 0.00). The leading indication for ‘twin’ caesarean section was previous section while that for singleton caesarean section was feto-pelvic disproportion. There was no maternal death in the twin caesarean section group while 15 maternal deaths occurred in the singleton group (i.e. a maternal death rate of 6 per 1000 sections). The maternal morbidity was also less in the twin than in the singleton group because more of the latter were complicated cases. The perinatal mortality rates were 26 and 63 per 1000 for the twin and singleton caesarean sections respectively. The perinatal mortality rates were lower in the caesarean delivered twins than in the vaginally delivered ones. Conclusions: The above demonstrate that timely caesarean section has an important role to play in minimizing feto-maternal risks associated with t in pregnancies. Practitioners should, therefore, not hesitate to resort to caesarean section in twin pregnancies if called for.