Incidences of Twin Pregnancies, Fetal Outcomes and Complication Affecting the Mother in AL-Gomhori Hospital in Taiz, Yemen
Abstract
Background
Multiple pregnancies are much more common today than they were in the past. Twin pregnancies occur in about 4% of pregnancies in some countries. Adverse pregnancy outcome was more common in twin pregnancy than in singleton pregnancy.
Study Objectives
The study generally aims to highlight the incidence of twin pregnancies in Al Gomhori hospital, Taiz, Yemen over a year (from Oct 1st 2024 to Sep 30th 2025)
Study Design
A prospective observational study.
Subjects and Methods
A questionnaire was constructed to collect data about each woman admitted to the hospital with twin pregnancies. The questionnaire included the important data about the mothers, such as age, parity, associated factors of twin pregnancy, antenatal healthcare, complications during pregnancy and delivery, gestational age at delivery, mode of delivery, and the condition of the mothers and the newborns after delivery. The data were collected and analyzed using SPSS software.
Results
The study found that 115 women gave birth to twins, resulting in the incidence of twin pregnancy as 1.3% in the hospital. The majority of these women (37.3%) were multipara. Their mean age was 29.16 ± 5.4 years, ranging from 18 to 40 years. A previous personal twin pregnancy accounted for 8.4% of the women, while a family history of twin pregnancies was present in 67.8% of the maternal side and 15.7% paternal side. Obesity was present among these women (20.9%). A total of 97.3% of the women had received prenatal care, while only three women did not attend antenatal care. Maternal complications included anemia (60.8%), premature birth (53.9%), urinary tract infections (29.5%), preeclampsia (9.5%), and polyhydramnios (8.7%). The most common complication during delivery was rupture of membranes (10.4%), and postpartum complications included postpartum hemorrhage (7.8%) and retained placenta (3.4%). Smoking was not significantly associated with preterm birth, but khat use had a statistically significant effect (P <0.001). The rate of cesarean section reaching 44.3%, the most common indication being non- cephalic presentation of the first twin. The most common fetal complications were premature birth and its consequences (53.9%), fetal injury (6.9%) twin discordance (16.5%), and others. The study did not observe any differences in the Apgar score at five minutes between the first and second twins. Seven of the first twins and seven of the second twins were stillborn. The mean birth weight of the first twin was 2157.86 ± 638.1 grams, and the mean birth weight of the second twin was 2071.40 ± 623.3 grams. The perinatal mortality was 73.91 per 1000 births
Conclusion
The incidence of twin pregnancy in the hospital observed in this study is 1.3% similar to the global incidence. The majority of women were multiparous and the incidence of twin pregnancy increased with increasing maternal age. Twinning was detected more among women with family history particularly along the maternal side. The majority of twin pregnancies were diagnosed during antenatal care. Anemia, premature birth, urinary tract infection, preeclampsia, polyhydramnios, pressure symptoms, PROM, and PPH were the most frequent maternal complications. The rate of cesarean section was lower than that of vaginal delivery with no combined mode of delivery for the second twin. The commonest indication of the cesarean section was non-vertex presentation of the first twin followed by prior scar. Prematurity, discordance, fetal demise, and congenital anomalies were the most frequent fetal complications. The mean birth weight for the first twin was higher than the second one with no statistical difference between the first and second twin in relation to Apgar score at 5 minutes.
