title: Retained second twin: experience from Ile-Ife, Nigeria.
abstract: BACKGROUND
  Retained second twin contributes significantly to perinatal morbidity and mortality, as well as maternal morbidity and mortality, usually arising as a result of intervention to salvage the retained foetus.
  
  
  OBJECTIVE
  To review the current incidence, management, fate and outcome of both the retained foetus and its mother, with a view to proffering solution.
  
  
  METHODS
  Retrospective review over a 12 year period from January 1988 to December 1999.
  
  
  METHODS
  Obafemi Awolowo University teaching hospital, Ile Ife, Nigeria.
  
  
  METHODS
  All cases of retained second twin managed during this period.
  
  
  METHODS
  Causes, sources of referral, perinatal and maternal complications.
  
  
  RESULTS
  The incidence is still high (7.9%). Majority of the patients were referred from rural centers (49.6%) and in poor fetal conditions (41.9%). The fetal survival in patients that presented within two hours of delivery of the first twin was 74.2%. The perinatal and maternal mortality were 47.3% and 3.9% respectively.
  
  
  CONCLUSIONS
  The incidence and associated maternal and fetal complications of retained twin is still rather high. Therefore, irrespective of the antenatal course and early labour findings, the conduct of twin deliveries must be in a well-equipped health institution with adequate staff. There should also be an efficient referral system for occasional emergencies from the peripheral centres.
authors.affiliation: Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State Nigeria.
authors.forename: O C
authors.initials: OC
authors.lastname: Ezechi
authors.forename: O B
authors.initials: OB
authors.lastname: Fasubaa
authors.forename: B E K
authors.initials: BE
authors.lastname: Kalu
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D046689:Fetal Mortality; D006771:Hospitals, Maternity / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D008428:Maternal Mortality; D009549:Nigeria / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000628:therapy; D009775:Obstetrics and Gynecology Department, Hospital / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data*; D011644:Puerperal Disorders / Q000453:epidemiology; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D016019:Survival Analysis; D014427:Twins