title: Higher-order multiple births in Abakaliki, Southeast Nigeria.
abstract: BACKGROUND
  Higher-order multiple births have implications for perinatal and maternal morbidity and mortality. This study aimed to determine the incidence and outcomes of higher-order multiple pregnancies in a rural area in Southeast Nigeria.
  
  
  METHODS
  The study reviewed the data on all higher-order multiple deliveries conducted in two tertiary health institutions in Abakaliki over a seven-year period from January 2000 to December 2006.
  
  
  RESULTS
  Higher-order multiple births constituted 0.13 percent of the 16,968 deliveries at the two institutions. There were 21 triplet births and one quadruplet delivery. Mothers with higher-order multiple pregnancies had more antenatal admissions for preterm uterine contractions and had more preterm deliveries. The vaginal route was the preferred method of delivery. Stillbirth was recorded in 12.7 percent of the triplets, with 25.5 percent involving triplets I, II and III, who suffered birth asphyxia. The perinatal mortality rate was 276 per 1,000.
  
  
  CONCLUSIONS
  The Igbo women of Ebonyi State, Nigeria, have a high rate of higher-order multiple births. These are attended by increased obstetric and perinatal complications. Abdominal delivery is therefore recommended in order to reduce the rate of intrapartum stillbirth and birth asphyxia among triplets.
authors: Department of Obstetrics and Gynaecology, Ebonyi State University, Abakaliki-Enugu Expressway, Abakaliki, Ebonyi State 480001, Nigeria. oujair@yahoo.com
authors: O U J
authors: OU
authors: Umeora
authors: E A
authors: EA
authors: AneziOkoro
authors: V E
authors: VE
authors: Egwuatu
mesh_terms: D000328:Adult; D001724:Birth Weight; D044383:Black People; D005260:Female; D005313:Fetal Death; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D008423:Maternal Age; D009549:Nigeria; D011247:Pregnancy; D011272:Pregnancy, Multiple; D011783:Quadruplets; D012189:Retrospective Studies; D012424:Rural Population; D016896:Treatment Outcome; D014310:Triplets; D014427:Twins