analysis of fetal and maternal morbidity and mortality in retained second twin

ABSTRACT

To evaluate the maternal morbidity, fetal morbidity and mortality related to retained second twin. Design: A prospective study. Place and Duration of Study Jinnah Hospital, Lahore from July 1996 to March 1998. Materials and Patients presenting to the labor ward after having delivered the first twin at home and with retention of the second twin in utero were included in the study. A total number of 7 patients were included in this study. Result: Malpresentation was seen in 3 patients [42.83%] and uterine inertia in 2 [28.57%] were found to be the commonest reasons for causing retention of second twin, while uterine inertia and malpresentation together was seen in 1 patient [14.28%] and cephalopelvic disproportion in 1 patient [14.28%]. The perinatal mortality rate was 71.42%. Maternal morbidity like fever was seen in 4 patients [57.14%], while postpartum hemorrhage was seen in two patients [28.75%]. Blood transfusion was required in 5 patients [71.42%]. Complications like scar dehiscence was also seen. In postpartum period breast engorgement requiring treatment with bromocriptine was seen in 3 patients [42.83%]. Retained second twin is associated with a high perinatal mortality rate and also causes increased morbidity in mother. Thus, patients with twin gestation should be referred earlier to a center equipped to handle such a high risk pregnancy and its associated problems at birth; and the problem of retained second twin should not be allowed to develop in a teaching hospital