Incidence and Outcome of Higher Order Multiple Pregnancies at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria

Abstract

Background: Higher Order multiple pregnancies (HOMP) increase the demand for neonatal intensive care services and knowledge of local  prevalences may be useful in planning neonatal intensive care.
Objectives: To determine the incidence and feto-maternal outcome of higher order multiple births in university of Nigeria Teaching Hospital  (UNTH), Ituku/Ozalla, Enugu, Nigeria.
Methods: It was a retrospective review of all HOMP at the UNTH Ituku/Ozalla Enugu, over a ten year period from June 2006 to May 2016.
Results: During the study period, there were 8207 deliveries out of which 23 were higher order multiple (HOM) births; consisting of 19 triplets and 4  quadruplets. The overall incidence of HOM births was 0.28%. This was made up of incidences of triplet and quadruplet births of 0.23% and 0.05% respectively. Ten (43.5%) of the women conceived spontaneously while 8 (34.8%) had ‘artificial reproductive technology’ and the remaining 5 (21.7%) took ovulation inducing agents. The maternal outcome of HOM births was generally good with no record of maternal death. The neonatal  complications included: neonatal jaundice (4.5%), birth asphyxia (4.3), conjoined twins (4.3) and neonatal death (13.0%).
Conclusions: The incidence of HOMP in UNTH, Ituku/Ozalla, Enugu is much less than 1% and comparable to that in other parts of the world. The overall maternal outcome of HOMP was good. There is however need for improved neonatal care to ensure better fetal outcome of HOMP in our setting.