Pregnancy outcomes in twin gestation
Twin gestation is generally associated with significant feto-maternal complications. Women with twin pregnancy need more contact with the health care provider during the antenatal period. This study evaluated the pregnancy outcomes in women with twin gestation at a central hospital in Bulawayo, Zimbabwe. The study was conducted at Mpilo Central Hospital, a tertiary health institution in Zimbabwe from 1 January 2017 to 31 July 2017. It was based in labour ward and postnatal ward. The inclusion criteria was women with twin gestation attending Mpilo Central Hospital maternity unit for delivery at or above the gestational age of 28 weeks. The objective was to determine the pregnancy outcomes in women with twin gestation. A data collection form was used to record data on patient demographics, antenatal information, and maternal and perinatal outcomes. The main outcomes were booking status, gestational age at booking, antenatal hospitalization, PPROM, hypertensive disorders of pregnancy, anaemia, preterm labor and delivery, cesarean section, HIV infection, stillbirth, NICU/ SCBU admissions, birth asphyxia, prematurity and low birth weight. The statistical analyses were performed using the Statistical Package for Social Sciences (SPSS version 20). Basic descriptive statistics were used to describe maternal characteristics and delivery outcomes for different categories. The results were presented using tables and graphs. Chi-square test analyses were performed to measure the relationship between some outcomes. During the study period, a total of 5 072 deliveries occurred at Mpilo Central Hospital. 117 (2.31%) of the women had twin gestation of which 115 (98.3%) were enrolled into the study. This study showed that women with twin gestation are at high risk of adverse outcomes. 39.1% were unbooked, 26.1% were HIV positive, and 40% were hospitalized during antenatal period. There was high risk of hypertensive disorders which affected 28.7% of mothers, preterm labor (36.5%), PPROM/ PROM (20.9%), anaemia (27.8%), caesarian delivery (43.5%) and postpartum haemorrhage (15.7%). Babies were also at high risk adverse perinatal outcomes which included prematurity which affected 48.7% of the babies, low birth weight (49.6%), birth asphyxia (7.8%), respiratory distress (12.2%). 35.2% of the babies were admitted into NICU or SCBU.