Peripartum complications of undiagnosed twin pregnancy at Korle Bu Teaching Hospital, Accra, Ghana

Abstract

The challenging situation of twin delivery is heightened when the multiple pregnancy is undiagnosed. Though the diagnosis of twin pregnancy is fairly easy, undiagnosed cases continue to be common, often presenting as retained second twins at the Korle Bu Teaching Hospital, Accra. The objectives of this study were to find out why some twin pregnancies remain undiagnosed till the time of delivery and the peripartum complications associated with the said cases. Of the 806 twin deliveries during the two-year period of 1997-98, 181 (22.45%) were undetected before delivery. The undetected cases either had no antenatal care or had sub-standard care. There were significantly more major peripartum maternal and fetal complications among the undiagnosed twin deliveries than those diagnosed as at the time of delivery. The main periparturn complications were eclampsia, preterm labour, antepartum haemorrhage from placenta previa and postpartum haemorrhage. Good antenatal care in patients managed by levels A and B of the Primary Health care system can improve the detection rates of twin pregnancy and hence a better maternal and fetal outcome.