Objective: Conduct a study on the maternal and neonatal prognosis of twin deliveries within the Gynecology and Obstetrics Department of Sourô Sanou Teaching Hospital of Bobo-Dioulasso. Methodology: This was a descriptive and cross-sectional study on 173 twin deliveries within the Gynecology and Obstetrics Department of Sourô Sanou Teaching Hospital of Bobo-Dioulasso (CHUSS) from January 1st to December 31st, 2019 i.e., a 12-month period.
Any parturient with a twin pregnancy having ≥ 28 weeks of amenorrhea, admitted and treated within the department for delivery was included in this study; female patients received for second the twin retention were also taken into account. The parameters studied were the following: 0sociodemographic characteristics, clinical examination and twin delivery data, maternal and neonatal prognosis. Information was collected from a survey form in addition to clinical records, prenatal consultation booklet, registers (delivery room, operating room, postoperative, and postpartum planning register).
Data were entered and analyzed through Word and Epi-Info version 22.214.171.124 software.
Results: During the period of study, 4086 deliveries were recorded among which 1,325 cesarean section deliveries. 173 twin deliveries were recorded corresponding to a frequency of 4.23%. The average age was estimated at 29 years [16-42 years] with the average parity reaching 2 [0-9]. Married women represented 54.91% of the total number of patients. Family twinning notion was found in 94.22% of cases and the use of ovulation inducer sin 5.78% of cases. The twin pregnancy average term was 38 weeks of amenorrhea. Excessive uterine height was the most common reason for hospital admission. The first twin was in a cephalic position in 71.68% of cases. Vaginal delivery was performed in 63% of cases of twin pregnancy against 26.01% of cesarean section delivery. As for the type of twinning, the twin pregnancy was dichorionic-diamniotic in 68.22% of cases, monochorionic-monoamniotic in 4.62% of cases and monochorionic-diamniotic in 27.16% of cases. Neonatal complications were related to prematurity and neonatal distress. We observed 12 neonatal deaths (3.70%). Maternal complications were observed in 12.13% of cases with a predominance of anemia, severe preeclampsia and endometritis. Maternal death was observed in 3 cases (1.72%).
Conclusion: Twin deliveries are relatively frequent in our department because of medical evacuations. The presence of well-trained practitioners is necessary for the evaluation of the maternal and fetal situations in order to make the relevant decisions. A good knowledge of obstetrical maneuvers is essential for the delivery of the second twin which requires an active attitude to increase the chances of successful rescue of the latter. In case of pathologies associated with twin pregnancy, prematurity, dystocia presentation of one or both twins, the onus lies on the obstetrician to make the most life-saving decisions to reduce the morbidity and mortality of the mother and the newborns.