Pregnancy outcome of women with twin gestation who delivered in Kenyatta National Hospital in 2015.
View/ Open
Date
2017Author
Njoroge, M Wairimu
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
INTRODUCTION: Twin pregnancies are considered high-risk pregnancies due to inherent biological factors that put the woman as well as the babies at increased risk. Despite only comprising about 2%, they contribute significantly to maternal and perinatal morbidity and mortality. This study will evaluate the outcomes of these high-risk pregnancies at the facility, it will therefore be important in improving care for twin pregnancies.
OBJECTIVE: To determine the maternal and perinatal outcomes of women with twin pregnancies delivering at Kenyatta National Hospital.
STUDY DESIGN: A hospital based Retrospective Descriptive Cross-sectional study.
STUDY SETTING AND SITE: The study was conducted at the Department of Reproductive Health, KNH.
STUDY POPULATION: The study population was women with a diagnosis of twin pregnancy who delivered at KNH from 1st January 2015 to 31st December 2015.
SAMPLE SIZE: A total of 287 of women with twin pregnancies delivered at KNH during the study period. The sample size was calculated as 141, however a total 203 files with the prerequisite information were reviewed
Outcome measures: Maternal: Pregnancy induced hypertension (PIH), Preterm labour and delivery, APH, PPH, C/S rates and maternal mortality. Perinatal outcomes: IUFD/ still births, Low birth weight, Apgar scores <7 at 5 minutes, admission to NBU/NICU.
DATA COLLECTION: Data was collected using a structured abstraction form prepared by the principal investigator.
DATA ANALYSIS: Data analysis was done via SPSS version 20.
RESULTS
Frequency of twin deliveries in KNH was 1 in 55 deliveries. Twinning in this study did not increase with age or parity. Majority of the patients were primigravida(31%). 80.8% of the cases the diagnosis was made during the antenatal period, 76% by obstetric ultrasound. 53.7% of the mothers delivered before 37 completed weeks. Most (80.5%) of the deliveries were cesarean sections. There was significant association between the mode of delivery and level of education OR 2.93(95% CI 1.10-7.84) p = 0.032. Chorionicity did not influence the mode of delivery p=0.11. The most common maternal complication was preterm delivery with 139(53.7%) delivering before 37 completed weeks. There were 52 (25.6%) mothers who had
pregnancy induced hypertension, PROM was reported in 33 (16.3%) of mothers, anemia in 26 (12.8%) and PPH occurred in 25 (12.3%). Majority of the twins were live births 97.5% for the first twins and 91% for the second twins. Second twins were 5 times more likely to suffer mortality compared to first twins OR 5.33(95% CI 1.53-25.6) p= 0.003. The odds of mortality were approximately three times higher among second twins delivered through cesarean section (AOR = 3.67, 1.08-20.5) p=0.033. The remaining perinatal outcomes were not significantly associated with birth order: low APGAR (p = 0.179), NBU admission (p = 0.074).
CONCLUSION
Maternal outcomes and neonatal outcomes in this study were found to be comparable to similar studies elsewhere. The cesarean section rate for twins was found to be 80.5%, this was high compare to similar studies done elsewhere. Standardization of care for twin gestations at the facility may reduce the cesarean section rate.
Publisher
University of Nairobi
Subject
Twin GestationRights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
The following license files are associated with this item: