Introduction: Twin births are high-risk deliveries. Guidelines for managing these deliveries are generally developed by countries with a high economic status. The objective of this study was to evaluate the clinical practice of the department in relation to twin deliveries. Methodology: This is a study based on a retrospective analysis of obstetric records from the maternity ward of the Gabriel Touré University Hospital over a 20-year period. Results: In this series, 3.7% of deliveries were twin deliveries, 58% of which were premature. The average age of the mothers was 26.6 years. Vaginal delivery was the mode of delivery in 60% of cases. Attempts at vaginal delivery of T1 in breech presentation were successful in 53.3% of multiparous women and 25.5% of nulliparous women. Perinatal mortality was 12% for cesarean sections and 17% for vaginal deliveries. Discussion: Similar rates of 3.7% have been reported in several studies in Mali. Vaginal delivery was the main mode of delivery. Scheduled cesarean section improves fetal prognosis. More than half of vaginal delivery attempts for T1 breech presentation were successful. Conclusion: Despite the absence of national guidelines in Mali, clinical practice in this department complies with the recommendations of the French National College of Gynecology and Obstetrics (CNGOF) regarding the mode of delivery.
References
[1]
Monden, C., Pison, G. and Smits, J. (2025) INED—National Institute for Demographic Studies. Twin Peak: The Rate of Twin Births Has Never Been Higher Worldwide. Press Room. https://www.ined.fr/fr/actualites/presse/pic-de-jumeaux-le-taux-de-naissances-gemellaires-n-a-jamais-ete-aussi-eleve-dans-le-monde/
[2]
Buanga, J.K. (2000) Difficulties in Managing Twin Pregnancy and Delivery in Africa. Médecined’Afrique Noire, 47, 8-9.
[3]
Haidara, Y. (2010) Twin Pregnancy and Delivery at the Sominé Dolo Hospital Maternity Ward. A Prospective Case-Control Study of 62 Twin Pregnancies versus 124 Single Pregnancies from January 1 to December 31, 2008. Thesis, University of Bamako.
[4]
Cngof, F. (2004) Ciane Bibliographical Database. Inter-Association Collective on Birth (CIANE). Journal de Gynécologie, d’Obstétrique et de Biologie de la Reproduction, 29, 9-108.
[5]
Oliver, E., Navaratnam, K., Gent, J., Khalil, A. and Sharp, A. (2023) Comparison of International Guidelines on the Management of Twin Pregnancy. EuropeanJournalofObstetrics&GynecologyandReproductiveBiology, 285, 97-104. https://doi.org/10.1016/j.ejogrb.2023.04.002
[6]
Traoré, C. (2015) Twin Pregnancy and Delivery in the Gynecology and Obstetrics Department of the Reference Health Center of Commune II of the District of Bamako.
[7]
Zedini, C., Bannour, R., Bannour, I., Bannour, B., Jlassi, M., Goul, L., et al. (2020) Twin Deliveries and Maternal-Fetal Prognosis in a Tunisian Level 3 University Center: A Retrospective Study of 399 Cases. PanAfricanMedicalJournal, 36, Article 237. https://doi.org/10.11604/pamj.2020.36.237.19179
[8]
Camara, N. (2006) Twin Pregnancies and Deliveries at the Maternity Ward of the Point G National Hospital. A Retrospective Case-Control Study of 505 Twin Pregnancies vs. 18,599 Single Pregnancies from 1985 to 2003. Thesis, University of Bamako.
[9]
Théra, T., Mounkoro, N., Traore, S.O., Hamidou, A., Traore, M., Doumbia, S., et al. (2018) Twin Delivery in Africa: A 10-Year Analysis in the Bamako district of Mali. PanAfricanMedicalJournal, 29, Article 21. https://doi.org/10.11604/pamj.2018.29.21.14277
[10]
Vendittelli, F., Accoceberry, M., Savary, D., Laurichesse-Delmas, H., Gallot, D., Jacquetin, B., et al. (2009) Recommendations for Clinical Practice: Which Mode of Delivery for Twins? JournaldeGynécologieObstétriqueetBiologiedelaReproduction, 38, S104-S113. https://doi.org/10.1016/s0368-2315(09)73567-7
[11]
Pascalet, M., Fourel, M., Bourtembourg, A., Toubin, C., Coppola, C., Becher, P., et al. (2019) Mode of Delivery of Twin Pregnancies with the First Twin in Breech Position after the Introduction of a Policy of Planned Caesarean Delivery for Nulliparous Women. EuropeanJournalofObstetrics&GynecologyandReproductiveBiology, 234, 58-62. https://doi.org/10.1016/j.ejogrb.2018.11.023
[12]
Bourtembourg, A., Ramanah, R., Jolly, M., Gannard-Pechin, E., Becher, P., Cossa, S., et al. (2012) Twin Delivery When the First Twin Is in Breech Presentation. Study of a Continuous Series of 137 Cases. JournaldeGynécologieObstétriqueetBiologiedelaReproduction, 41, 174-181. https://doi.org/10.1016/j.jgyn.2011.10.005
[13]
Jolly, É. (2016) Delivery of Twin Pregnancies When the First Twin Is in Breech Presentation. A Continuous Series of 75 Cases at Amiens-Picardie University Hospital. Université de Picardie Jules VERNE. https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url= https://dumas.ccsd.cnrs.fr/dumas-01549043v1/document&ved=2ahUKEwjhhaSVkaiOAxV_VKQEHSaqB7gQFnoECB4QAQ&usg=AOvVaw3YgRqqyglQBs3P83X2a4Cd
[14]
Bats, A.S., Marie, V., Sentilhes, L., Cabrol, D. and Goffinet, F. (2006) Twin Pregnancy and Breech Presentation at Term: Is Natural Delivery Still Acceptable? Retrospective Comparison of Perinatal Outcomes According to the Choice of Delivery Method in 166 Deliveries. Journal de Gynécologie, d’Obstétrique et de Biologie de la Reproduction, 35, 584-593.
