medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2015, Number 10

<< Back Next >>

Ginecol Obstet Mex 2015; 83 (10)

Perinatal outcomes of twin pregnancies conceived through in vitro fertilization versus spontaneous

Rubio-Cid P, Álvarez-Silvares E, Alves-Pérez MT, García-Lavandeira S, Pérez-Adán M

Language: Spanish
References: 24
Page: 602-613
PDF size: 420.69 Kb.


ABSTRACT

Objective: Determine maternal and fetal characteristics of in vitro fertilization twin pregnancies in comparison with spontaneous twin pregnancies.
Material and methods: Retrospective historical cohort study between 2011 and 2013. Statistical analysis was performed with SPSS 15.0 program and Epidat 3.0. A value of p‹0.05 was considered statistically significant.
Results: 96 twin pregnancies met inclusive criteria with an incidence of 2.01%, of which 54.16% were spontaneous twin pregnancies and 45.83% in vitro fertilization twin pregnancies. Mean maternal age at delivery was higher in vitro fertilization twin pregnancies (p=0.004). The primigravidae were more frequent in vitro fertilization twin pregnancies group (p‹0.001). Monochorionic pregnancies percentage was superior in spontaneous pregnancies (p=0.009). Amenorrhea at delivery was not a significant difference between cohorts (p=0.9). Preterm rate was superior in spontaneous twin pregnancies group (p=0.003). However, “great preterm deliveries” were higher in in vitro fertilization twin pregnancies (p‹0.001). Significant differences were not observed in fetal presentation at delivery, first-born child birth-weight or intrauterine growth retardation between the two groups. Nevertheless, the mean birth-weight of second-born spontaneously conceived twins was higher than second-born twins of the in vitro fertilization conceived group (p=0.027). Gestational pathology presented the same distribution in both cohorts. There was no significant difference in the mode of delivery between the two groups. Total perinatal mortality rate was 20,83‰ and comprised 2 first born twins and 2 second born twins. Three of the stillbirths came from the spontaneous pregnancies group and one from the in vitro fertilization group.
Conclusions: Perinatal death was secondary to stillbirths, which we found higher in spontaneously conceived twin pregnancies due to higher number of monochorionic pregnancies.


REFERENCES

  1. Alvarez-Silvares E, Canedo-Carballeira EM, Dueñas-Carazo MB, Aguiar-Couto R, Alvarez-Menéndez L, Martínez- Martínez O, Devesa-Hermida R, y col. Encuesta perinatal de la Sociedad Gallega de Obstetricia y Ginecología. Prog Obst Ginecol 2014;57(3):109-116.

  2. Instituto Nacional de estadística. [en línea]. Dirección URL: . (Citado 04/04/2014).

  3. Cerrillo-Martínez M, González-Mirasol E, Díaz-Serrano MD, Tello-Muñoz A, González de Merlo G. Pronóstico perinatal y materno de las gestaciones gemelares concebidas mediante fecundación in vitro en relación con las obtenidas espontáneamente. Prog Obstet Ginecol 2007;50(2):88-97.

  4. Shebl O, Ebner T, Sir A, Sommergruber M, Tews G. The role of mode of conceptiion in the autcome of twin pregancies. Minerva Ginecol 2009;61(2):141-52.

  5. Instituto Galego de Estadística. [en línea]. Dirección URL: . (Citado 09/04/2015).

  6. Kessler L. The problem of older primipara. Obstet Gynaecol 1980;56:165-9.

  7. Zaib-un Nisa S. Outcome of twin pregnancies after assisted reproductive techniques: a comparative study. EurJ Obstet Gynaecol Reprod Biol 2003;109:51-4.

  8. Kanat-Pektas M, Kunt C, Gungor T, Mollamahmutoglu L. Perinatal and first year outcomes of spontaneous versus assisted twins: a single center experience. Arch Gynecol Obstet 2008;278:143-147.

  9. Joy J, McClure N, Cooke IE. A comparison of spontaneously conceived twins and twins conceived by artificial reproductive technologies. J Obstet Gynecol 2008;28:580-585.

  10. Hansen M, Colvin L, Petterson B, Kurinczuk JJ, Klerk N, et al. Twins born following assisted reproductive technology: perinatal outcome and admission to hospital. Hum Reprod 2009;24:2321-2331.

  11. Morcel K, Lavoué V, Beuchée A, Le Lannou D, Poulain P, Pladys P. Perinatal morbidity and mortality in twin pregnancies with dichorionic placentas following assisted reproductive techniques or ovarian induction alone: a comparative study. Eur J Obstet Gynecol Reprod Biol 2010;153:138-142.

  12. Delbaere I, Verstraelen H, Goetgeluk S, Martens G, Derom C, de Bacquer D, Temmerman M. Perinatal outcome of twin pregnancies in women of advanced age. Hum Reprod 2008;23:2145-50.

  13. Allen VM, Wilson RD, Cheung A. Genetics Committee of the Society of Obstetricians and Gynaecologists of Canada (SOGC); Reproductive Endocrinology Infertility Committee of the Society of Obstetricians and Gynaecologists of Canada (SOGC): Pregnancy outcomes after assisted reproductive technology. J Obstet Gynaecol Can 2006;28(3):220-50.

  14. McDonald S, Murphy K, Beyene J, Ohlsson A. Perinatal outcomes of in vitro fertilization twins: a systematic review and meta-analyses. Am J Obstet Gynecol 2005;193(1):141-52.

  15. Olivennes F. Perinatal outcome of twin pregnancies obtained after in vitro fertilization: comparison with twin pregnancies obtained spontaneously or after ovarian stimulation. Fertil Steril 1996;66:105-9.

  16. Hansen M, Colvin L, Petterson B, Kurinczuk JJ, de Klerk N, Bower C. Twins born following assisted reproductive technology: perinatal outcome and admission to hospital. Hum Reprod 2009;24:2321-2331.

  17. Morcel K, Lavoue V, Beuche A, Le Lannou D, Poulain P, Pladys P. Perinatal morbidity and mortality in twin pregnancies with dichorionic placentas following assisted reproductive techniques or ovarian induction alone: a comparative study. Eur J Obst Gynecol Reprod Biol 2010;153:138-142.

  18. Jackson RA, Gibson KA, Wu YW, Croughan MS. Perinatal outcomes in singletons following in vitro fertilization: a meta-analysis. Obstet Gynecol 2004;103:551-63.

  19. Szymusik I, Kosinska-Kaczynska K , Bomba-Opón D , Wielgos M. IVF versus spontaneous twin pregnancies-which are at higher risk of complications? J Matern Fetal Neonatal Med 2012;25(12):2725-8.

  20. Fan C, Sun Y, Yang J, Ye J, Wang S. Maternal and neonatal outcomes in dichoronic twins and neonatal in dichorionic twins pregnancies following IVF treatment: a hospital-based comparative study. Int J Clin Exp Pathol 2013;6(10):2199-207.

  21. Pinborg A, Loft A, Schmidt L, Langhoff-Roos J, Andersen AN. Maternal risks and perinatal outcome in a Danish national cohort of 1005 twin pregnancies: the role of in vitro fertilization. Acta Obstet Gynecol Scand. 2004;83(1):75-84.

  22. Pinborg A, Loft A, Schmidt L, Langhoff-Roos J, Andersen AN. Maternal risks and perinatal outcome in a Danish national cohort of 1005 twin pregnancies: the role of in vitro fertilization. Acta Obstet Gynecol Scand 2004;83(1):75-84.

  23. Daniel Y, Ochshorn Y, Giedon F, Geva E, Bar-Am A, Lessing JB. Análisis of 104 twin pregnancies conceived with assisted reproductive technologies and spontaneously conceived twin pregnancies. Fertil Steril 2000;74(4):683-8.

  24. Lambalk CB, Van Hoof M. Natural versus induced twinnig and pregnancy outcome: a Dutch nation wide survey of primiparous dizygotic twin deliveries. Fertil Steril 2001;75(4):731-5.




2020     |     www.medigraphic.com