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Angela Onwuzoo
Maternal health experts have urged women pregnant with twins or more babies to ensure they seek special care from maternal health specialists to reduce the complications associated with multiple pregnancies.
According to the experts in female reproductive health, being pregnant with twins carries a higher risk of premature delivery, adding that giving birth to preterm babies also comes with a lot of other risks.
The experts noted that the survival of premature babies is slim, especially when they are born before 37 weeks, stressing that twin gestation is also associated with birth defects.
To minimise the risk of preterm delivery and its associated problems, the physicians urged women with twin gestation to be faithful to their antenatal visits and promptly report their concerns to their doctors.
An Associate Professor, at the College of Medicine, Lagos State University, Dr. Yusuf Oshodi, in an exclusive interview with PUNCH HealthWise, said delivering babies prematurely, comes with lots of risks because the babies are delivered when they are not mature enough to come out and therefore, find it difficult to cope with the outside world.
Dr. Oshodi, who is also a Consultant Obstetrician & Gynaecologist at the Lagos State University Teaching Hospital, Ikeja, said one out of three babies born before 37 weeks would die.
The gynaecologist explained, “People carrying more than one baby have a higher chance of preterm delivery which will lead to premature babies.
“Beginning from 28 to 32 weeks, there could be a delivery, and between 34 and 36 weeks, there could be a delivery. Also, between 35 and 36 weeks, there could be delivery and 36 weeks and above. So, the closer the babies are to term, the higher their chance of survival.
“If the woman delivers around 29 weeks, of course, the chance of survival of those babies will be slim due to various problems, but mainly because they are not mature enough to come out.
“Their body system is not old enough to cope with the outside world. So, that is the main cause why premature babies die. Babies delivered before 37 weeks, their chance of survival is slim and one out of three of them will die.”
Dr. Oshodi noted that besides the challenges of managing babies delivered preterm, mothers pregnant with twins from the beginning of conception have double the challenges associated with pregnancy.
“The stress that the woman will be going through will be doubled, vomiting and dizziness will be doubled, even the risk of high blood pressure is higher in people who are carrying twins than those carrying one baby.
“In terms of diabetes in pregnancy, the chance is higher in people who carry twins compared to a person who is carrying one baby. Even the risk of congenital malformations (congenital anomalies) are also higher in twin pregnancy,” he said.
Following the listed challenges, the gynaecologist said the woman might also find it difficult to deliver on her own.
Dr. Oshodi also said that women with twin pregnancies also stand the risk of bleeding which he said could lead to preterm delivery.
“When this happens, we have to deliver the woman earlier than necessary,” said.
Commenting further on why premature babies die, the maternal health expert stated that premature babes have lots of problems to deal with including difficulty in maintaining sugar levels.
He said, “Their liver is not mature enough and because their liver is not mature enough, they tend to have neonatal jaundice. They have a high risk of infection, feeding problems, and digestion problems.”
He urged pregnant women that are carrying twins to ensure that they start antenatal early and also ensure they deliver in the hospital where there are maternal and child health specialists.
Also, speaking, a Consultant Obstetrician and Gynaecologist, Dr. Bright Airhumwunde, says the survival of babies born from multiple births in Nigeria is dependent on the age at which they were delivered.
Airhumwunde who is also the Chief Executive Officer of Crown Global Medicare said, “First of all, for twins, the average delivery time is about 36 to 37 weeks. For triplets, it is about 34 weeks; while for quadruplets, it is about 28 weeks.
“So, the more the foetuses, the earlier the delivery. At the end of the day, the survival of those babies depends on when they are delivered. Again, where they are delivered also matters.
“Rural women and women who lack access to healthcare are at increased risk of preterm delivery and subsequent death of the babies,” he said.
According to him, managing preterm babies in public hospitals is still a challenge in the country owing to the lack of equipment such as incubators, oxygen requirements, and special medications to mature the lungs of babies.
He said a lot of investment in terms of equipment and manpower to improve the survival of preterm babies in Nigeria was needed.
The United Nations Children’s Fund says more than 400,000 babies are born dead in Nigeria annually.
According to UNICEF, out of more than 2.5 million babies that are born dead globally each year, more than 400,000 stillborn deaths take place in Nigeria.
Data from the World Health Organisation says every year, an estimated 15 million babies are born preterm (before 37 completed weeks of gestation).
“Preterm birth complications are the leading cause of death among children under five years of age, responsible for approximately 1 million deaths in 2015.
Three-quarters of these deaths could be prevented with current, cost-effective interventions,” WHO said.
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