title: Retained second twins in Enugu, Nigeria.
abstract: OBJECTIVE
  To review our experience with retained second twin in Enugu, Nigeria, over a 10-year period.
  
  
  METHODS
  The second twin is retained when a delay of 30 min occurs after the delivery of the first twin. The case notes and records of all twin deliveries at the University of Nigeria Teaching hospital Enugu between January 1991 and December 2000 were retrieved and analyzed.
  
  
  RESULTS
  Retained second twin occurred in 1/6 twin deliveries with a resultant perinatal mortality rate of 288.5 per 1000 deliveries which was 1.7 times that of first twin. Malpresentation (54%) and uterine atony (39%) were the principal causes of retained second twins. The place of delivery of the first twin, prolonged birth intervals, oxytocin augmentation of labor and breech extraction affected perinatal outcome.
  
  
  CONCLUSIONS
  Early recourse to vacuum extraction and cesarean deliveries of retained second twin, effective health education and adequate supervision of primary health care facilities are advocated to reduce this preventable condition.
authors.affiliation: Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
authors.forename: U U
authors.initials: UU
authors.lastname: Aniebue
authors.forename: H U
authors.initials: HU
authors.lastname: Ezegwui
authors.forename: B C
authors.initials: BC
authors.lastname: Ozumba
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008423:Maternal Age; D008428:Maternal Mortality; D009549:Nigeria / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014427:Twins / Q000706:statistics & numerical data*