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Abam et al

Greener Journal of Medical Sciences

Vol. 11(2), pp. 226-233,  2021

ISSN: 2276-7797

Copyright ©2021, the copyright of this article is retained by the author(s)






A Review of Twin Gestations in a Tertiary Hospital in Port Harcourt.



Abam DS1; Onwubuariri M1*; Onunuju CN1; Owoi TJ1



Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital.1






Article No.: 111721126

Type: Review



Background: Twin gestation results from the conception of two fetuses at the same time in a woman. It can be monozygotic or dizygotic. Globally, twins have the highest incidence amongst the multiple gestations and are considered as high risk pregnancies. In Nigeria twinning has major obstetric significance because the highest rate in the world occurs in this country, with an incidence of 54 in 1000 births.

Aim: This is to review twin gestations at the University of Port Harcourt Teaching Hospital (UPTH).

Method: This was a retrospective descriptive study of twin gestations carried out in the Department of Obstetrics and Gynaecology, UPTH over a 5-year period. The data obtained were recorded in a personal computer and analysed using Statistical Package for Social Sciences (SPSS) software package (version 23.0; Chicago, Illinois, USA). Simple frequency tables and charts were used to illustrate the analysed data. The Student’s t-test was used to assess for statistically significant differences between groups with a value of p<0.05 considered statistically significant.

Results: There were 6850 deliveries for the period under review, with 238 twin deliveries, out of which 232 case notes were retrieved; giving a case note retrieval rate of 97.5%. The   incidence of twin delivery was 33.8 per 1000 deliveries. The mean age and parity were 28.99 ± 4.71 years and 2.30 ± 1.49 respectively.  Multiparous women had the highest number of twin deliveries, accounting for 49.6%. For mode of conception, assisted reproductive technology (ART) made up 27.2%, while 72.8% of the cases conceived naturally. For the mode of delivery in twin pregnancies in this study caesarean section accounted for 38.4%, while 61.6% had vaginal delivery. The male-male sex combination was the most frequent, accounting for 29.7%. Same sex pair delivery accounted for 56.9% of twin deliveries. The cephalic-cephalic presentation combination was also predominant, accounting for 46.9%. The average gestational age at delivery of twins was 37.4 ± 2.27 weeks. The commonest maternal complications were those of preterm delivery, abnormal presentation, hypertensive disorders of pregnancy and anaemia. 

Conclusion: The study revealed the incidence of twin delivery was 33.8 per 1000 deliveries. A significant percentage conceived through ART (27.2%) and delivered by caesarean section (38.4%). The male-male sex combination was the most frequent, accounting for 29.7%. Preterm delivery and malpresentation were part of the commonest maternal complications encountered. Twin pregnancy is a high risk pregnancy and this should always be managed as such to improve on the case outcomes.


Accepted:  18/11/2021

Published: 30/11/2021


*Corresponding Author

Onwubuariri M.I MBBS, FMCOG

E-mail: michaelonwubuariri@



Review, twin gestation, high risk pregnancies








1.       Isiaka-Lawal S,   Adesina KT, Ijaiya MA, Saidu R, Jimoh AAG, Aderibigbe SA. A review of twin gestations in a tertiary health institution in North Central Nigeria. Res J Med Sci. 2009; 3(6): 198-201.

2.        Oraekwe OI. Appraisal of maternal outcome of twin gestation. Saudi J Health Sci. 2018; 7: 163-6.

3.        Fakeye O. Twin birth weight discordancy in Nigeria. Intl J Gynecol Obstet. 1986; 24: 235-238.

4.       Kilby MD, Oepkes D. Multiple pregnancy. In: Edmonds DK, Lees C (Eds). Dewhurst’s Textbook of Obstetrics and Gynaecology. 9th edition. Wiley-Blackwell Publishing. Oxford. 2018; 268-81.

5.      Riese ML. Temperament prediction for neonatal twins: relation to size of gestational age in same sex pairs. Acta Genet Med Gamellol (Roma). 1992; 41(2-3): 123-125.

6.     Dickey RP, Taylor SN, Lu PY, Sartor BM, Storment BM, Rye PH, Pelletier WD, Zender JL, Matulich EM. Spontaneous reduction of multiple pregnancy: incidence and effect on outcome. Am J Obstet Gynecol. 2002 Jan; 186(1): 77-83.

7.      Newmann RB. Multiple gestation. In: Gibbs RS(Ed). Danforths Obstetrics and Gynaecology. 9th edition. Lippincott Williams & Wilkins. 2008; 239-244.

8.       Iyiola OA, Oyeyemi FB, Raheem UA, Mark FO. Frequency of twinning in Kwara, North-Central, Nigeria. Egyptian J Med Hum Genet. 2013; 14(1): 29-35.

9.      Pison G, Monden C, Smits J. Twinning rates in developed countries: trends and explanations. Population and Development Review. 2015; 41(4): 629-49.

10.   World Health Organization: Neonatal and perinatal mortality: country, regional and global estimates. Geneva: WHO; 2016.

11.   Aisien AO, Olarewaju RS, Imade GE. Twins in Jos, Nigeria: a seven year retrospective study. Med Sci Monit. 2000; 6(5): 945-950.

12.    Bassey G, Inimgba NM. Fetomaternal outcome of twin gestation in Port Harcourt, South-South, Nigeria. Niger J Med. 2014; 23(4): 282-7.

13.   Eskandar M. Outcome of twin ICSI pregnancy compared with spontaneous conceived twin pregnancy: a prospective, controlled, observational study. Mid East Fer Soc J. 2007; 12(2): 93-7

14.   Andrijasevic S, Dotlic J, Aksam S, Micic J, Terzic M. Impact of Conception Method on Twin Pregnancy Course and Outcome. Geburtshilfe und Frauenheilkunde. 2014; 74(10): 933–39.

15.    Yakasai IA, Rabiu A.  Twin births in Kano, Northern Nigeria.  IOSR J Pharm. 2013; 3(1): 4-8.

16.    Akinboro A, Azeez MA, Bakare AA. Incidence of twinning in South West Nigeria. Indian J Hum Genet. 2008; 14(2): 41-47.

17.    Mutihir JT, Pam VC. Obstetric outcome of twin pregnancies in Jos, Nigeria. Niger J Clin Pract. 2007; 10(1): 15-18.

18.   Fan C, Sun Y, Yang J, Ye J, Wang S. Maternal and neonatal outcomes in dichorionic twin pregnancies following IVF treatment: a hospital-based comparative study. Int J Clin Exp Pathol. 2013; 6(10): 2199-2207.

19.   Ibrahim I, Oyeyemi A, Obilahi A. Twin pregnancies in the Niger Delta of Nigeria: a four-year review. Int J Womens Health. 2012;4: 245–249.

20.    Obiechina N, Igwegbe A, Ugboaja J. An appraisal of caesarean section for twin pregnancies in a private hospital in South East Nigeria. Global J Med Res. 2010; 2(1): 22-25.

21.     Igberase GO, Ebeigbe PN, Bock- Oruma A. Twinning rate in a rural mission tertiary hospital in the Niger Delta, Nigeria. J Obstet Gynaecol. 2008; 28(6): 586-589.

22.   Chiwanga ES, Massenga G, Mlay P, Obure J, Mahande MJ. Maternal outcome in multiple versus singleton pregnancies in Northern Tanzania: a registry-based case control study. APJR. 2014; 3(1): 46-52.



Cite this Article: Abam DS; Onwubuariri M; Onunuju CN; Owoi TJ (2021). A Review of Twin Gestations in a Tertiary Hospital in Port Harcourt. Greener Journal of Medical Sciences, 11(2): 226-233.


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