Twin births in the Comoros.

OBJECTIVE To determine the prevalence and clinical significance of twin births in the Comoros Islands. DESIGN Combined retrospective and non-randomised prospective study. SETTING Hospital El-Ma'aru Moroni Grand-Comoros and Center Medico-Chirurgical Domoni-Anjouan. SUBJECTS One hundred and nine patients with twin deliveries. RESULTS During the period of study, there were 4370 deliveries, out of which 109 were twin births, giving an incidence rate of 25/1,000 deliveries. Twin births rate increased with increasing parity. The perinatal mortality rate of twin delivery was seven times that of singleton. Low birthweight rate was 54% among twin births. Retention rate of second twin was 12%, with home delivery of the first co-twin in 62% of cases. Uterine atony and malpresentation were the principal factors in the aetiology of retained second twin. CONCLUSION Multiple pregnancy is common in the Comoros and the epidemiology and clinical significance are consistent with established data. Clinicians and midwives in Comoros must be aware of these facts, and endeavour to make early diagnosis and institute appropriate management within the available scarce resources, in order to improve maternal and foetal outcome of twin births.