PERINATAL AND MATERNAL OUTCOME IN RETAINED SECOND TWIN

Objective: To evaluate the perinatal and maternal outcome related to retained second twin.Materia/ and Methods: This study was carried out in Gynae ʹBʹ Unit, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from January 2004 to December 2005. Patients presenting to the labour ward after having delivered the first twin at home and with retention of the second twin in-utero with time interval of more than 30 minutes after the delivery of the first twin were included in the study.Results: A total number of 25 patients presented with retained second twin during the above mentioned time period. Malpresentation in 14 patients (56%) and uterine inertia in 7 patients (28%) were found to be the commonest reasons causing retention of second twin, while malpresentation and uterine inertia together was seen in 4 patients (16%). The perinatal mortality was 76% (n = 19/25). Maternal morbidity like fever was seen in 12 patients (48%) while post partum hemorrhage occurred in six patients (24 %). Blood transfusion was required in 17 patients (68 %). In post partum period breast engorgement requiring treatment with bromocriptine was seen in 5 patients (20 %).Conclusion: Retained second twin is associated with a high perinatal mortality rate and also causes increased morbidity in mothers. 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.