The trend of higher-order multiple gestation in a tertiary hospital in South-South Nigeria

Rose Sitonma Iwo-Amah; Felix Clement C. Wekere; Uduak Ocheche; Peter Abiye Awoyesuku; Faithwin Horsefall; Elizabeth Bema

doi:10.18203/2320-1770.ijrcog20243151

Authors

Rose Sitonma Iwo-Amah Department of Obstetrics and Gynecology, Rivers State University Teaching Hospital, Port-Harcourt, Nigeria
Felix Clement C. Wekere Department of Obstetrics and Gynecology, Rivers State University Teaching Hospital, Port-Harcourt, Nigeria
Uduak Ocheche Department of Obstetrics and Gynecology, Pamo College of Medical Sciences, Port-Harcourt, Rivers State, Nigeria
Peter Abiye Awoyesuku Department of Obstetrics and Gynecology, Rivers State University Teaching Hospital, Port-Harcourt, Nigeria
Faithwin Horsefall Department of Obstetrics and Gynecology, Rivers State University Teaching Hospital, Port-Harcourt, Nigeria
Elizabeth Bema Department of Obstetrics and Gynecology, Rivers State University Teaching Hospital, Port-Harcourt, Nigeria

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20243151

Keywords:

Assisted reproduction technology, Higher-order multiple pregnancies

Abstract

Background: Higher-order multiple (HOM) Gestations are pregnancies with three or more fetuses within the uterus at the same time. The advent of assisted reproductive technology (ART) has caused an increase in its occurrence. Prevalence of naturally occurring HOM births is 1-7 per 10,000 deliveries. HOM are associated with adverse obstetric and perinatal outcomes, when compared with singleton births. In Nigeria, ART is gaining ground, after an initial reluctance. The aim of this study was to highlight the adverse obstetric and perinatal outcomes of HOM pregnancies and births in a tertiary hospital.

Methods: This was a retrospective study of 38 HOM pregnancies that delivered at the Rivers State University Teaching Hospital (RSUTH) between January 2019- December 2023. Relevant data was extracted from the patient’s hospital records. Data was entered into a pre-designed Proforma. Analysis was done using IBM.SPSS, version 25.

Results: A total of 9,538 deliveries took place within the study period. Two hundred and ninety (3.04%) were twin deliveries. Triplet deliveries were 33(0.35%). Quadruplets were a total of 4 (0.04%) and Quintuplets delivery was 1(0.01%). Prevalence of HOM births from this study was 3.7 per 1,000 deliveries. Complications associated with HOM deliveries for the parturient were anaemia (84.2%) and severe pre-eclampsia (42.12%). Perinatal complications were prematurity (92.12%), low birth weight (91.5%) and respiratory distress syndrome (90%).

Conclusions: There is an upward trend of HOM pregnancies due to ART, and advanced maternal age at conception. Proper antenatal care to prevent anemia, close monitoring of these pregnancies will help improve maternal and perinatal outcomes from HOM births.

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