7. Multiple pregnancy

Abstract

Summary. There were 357 twin pairs, six sets of triplets and one pair of conjoined twins born in the group of 15020 booked women compared with 392 twin pairs, 10 sets of triplets, two sets of quadruplets and two sets of conjoined twins in the 7654 emergency admissions (unbooked women). Rising maternal age, parity and height were all associated with rising twinning rate. Maternal death rates were 0.8% for singleton pregnancies, 2.0% for twin pregnancies, 6.3% for triplet pregnancies and none for the two women who had quadruplets. The mean fetal birthweights were 3.08 kg for singletons, 2.28 kg for twins, 1.71 kg for triplets and 1.36 kg for quadruplet babies. Fetal loss was 10% for singletons, 24% for twins, 42% for triplets and 75% for quadruplet babies. The poorer maternal and fetal outcomes in multiple pregnancy compared with those in singleton pregnancy were due to the combined effects of certain pregnancy complications, including the retention of the second twin, of inadequacies in our health care facilities and of unfavourable socioeconomic circumstances especially lack of antenatal care.