Salma K., 25

Salma lives with her husband, Musa, in Gasma Village, where they reside in a small two-bedroom house. Musa is a subsistence farmer and earns approximately ₦5,000, which is used to support the family’s basic needs. Salma contributes to the household by selling yam from home. Despite their efforts, the family has limited financial resources and struggles to meet daily expenses and unexpected medical costs. When Salma developed complications during her twin pregnancy, the family faced significant financial difficulty in accessing the emergency care she urgently needed. The abnormal presentation of the babies, together with evidence of foetal compromise, made her condition an obstetric emergency requiring prompt intervention to protect both mother and babies.

Doctor's Opinion Salma presented with malpresentation of a twin gestation complicated by foetal distress, a high-risk obstetric emergency. Maternal complications include severe postpartum haemorrhage and surgical trauma, while foetal complications include severe birth asphyxia, birth trauma, and neonatal death from prolonged hypoxia and difficult extraction. If left untreated, obstructed twin delivery would progress to uterine rupture, catastrophic haemorrhage, sepsis, and maternal death, while both babies would almost certainly die from prolonged oxygen deprivation. Prognosis The maternal prognosis is excellent with rapid surgical intervention. The foetal prognosis remains guarded, depending entirely on the speed of delivery to prevent permanent neurological damage or neonatal death.