Outcome of Twin Pregnancies at Nnamdi Azikiwe University Teaching Hospital, Awka, Anambra State

Twin pregnancies carry substantially elevated risks of maternal and perinatal complications compared to singleton gestations, and their management in tertiary Nigerian hospitals presents distinct challenges related to resource availability and monitoring capacity. This study describes the maternal and perinatal outcomes of twin pregnancies managed at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Awka, Anambra State, South East Nigeria. A five-year retrospective review of all twin deliveries from 2018 to 2022 was conducted using labour ward registers and case notes. Data were extracted on chorionicity, gestational age at delivery, mode of delivery, maternal complications, and perinatal mortality. A total of 142 twin pairs were delivered, constituting 2.1 percent of all deliveries. Preterm delivery before 37 weeks occurred in 58 percent of twin pregnancies. Preeclampsia complicated 22 percent of cases, and postpartum haemorrhage occurred in 18 percent. Caesarean section was performed in 71 percent of twin deliveries. Perinatal mortality was 98 per 1,000 twin births, with foetal growth restriction (34 percent) and prematurity (42 percent) as the leading contributors. Monochorionic twins had a significantly worse perinatal outcome than dichorionic pairs. Recommendations include dedicated twin pregnancy monitoring protocols, early identification of chorionicity by ultrasound, and improved neonatal intensive care capacity at NAUTH to reduce perinatal mortality in multiple gestations. Keywords: twin pregnancy, perinatal mortality, preterm delivery, NAUTH, multiple gestation