Fakeye O
Int J Gynaecol Obstet. 1986 Aug;24(4):309-14. doi: 10.1016/0020-7292(86)90089-5.
The results of a retrospective study involving 622 twin-pairs born over an 18-month period among 17,726 births at the University of Ilorin Teaching Hospital, Ilorin, Nigeria, are presented with particular reference to four variables: birthweight, presentation, parity, and intertwin delivery time interval. The twinning incidence was 35.1 per 1000. Monozygous and dizygous rates are 7 and 28 per 1000, respectively. Overall perinatal mortality (PNM) was 15.5%. Mortality was higher in second than in first twin (19.5% vs. 11.6%), and consistently higher when divided into birthweight groups. Corrected PNM increased with breech presentations: 16.3% in breech:breech compared with 3.9% in vertex:vertex presentations. The twinning rate increased with parity; PNM is low in parity 1, of little variation in birth-ranks 2-5, and high in para 6 and above. Delivery of the second twin within 15 min seems optimal, giving a corrected PNM 3.6% in contrast to rates of 10.1%, 14.0% and 19.1%, respectively when delivery occurred between 16 and 30, 31 and 60 and greater than 60 min, respectively. Prevention of preterm delivery, increased use of cesarean section delivery for malpresentation, active management of delivery of second twin within an optimal time of 15 min, and family planning are suggested in order to decrease twin PNM.
本文呈现了一项回顾性研究的结果，该研究涉及尼日利亚伊洛林大学教学医院17726例分娩中在18个月内出生的622对双胞胎，特别提及了四个变量：出生体重、胎位、产次和双胞胎分娩时间间隔。双胞胎发生率为每1000例中有35.1例。单卵双胎和双卵双胎的发生率分别为每1000例中有7例和28例。总体围产期死亡率（PNM）为15.5%。第二个双胞胎的死亡率高于第一个（19.5%对11.6%），并且按出生体重分组时一直较高。矫正后的PNM随着臀位分娩而增加：臀位：臀位的矫正PNM为16.3%，而头位：头位分娩的矫正PNM为3.9%。双胞胎发生率随着产次增加；产次为1时PNM较低，产次2 - 5时变化不大，产次6及以上时较高。在15分钟内分娩第二个双胞胎似乎是最佳的，此时矫正后的PNM为3.6%，相比之下，当分娩时间分别在16至30分钟、31至60分钟以及大于60分钟时，矫正后的PNM分别为10.1%、14.0%和19.1%。为了降低双胞胎的PNM，建议预防早产、增加对胎位异常的剖宫产分娩、在15分钟的最佳时间内积极处理第二个双胞胎的分娩以及计划生育。
