Maternal and perinatal outcome following assisted reproductive technology in a tertiary care centre: a retrospective study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20191529Keywords:
ART, Adverse outcomes of ART, Infertility, Perinatal complications, Renal failureAbstract
Background: Infertility is a major issue and a source of social and psychological suffering for many couples. Introduction of assisted reproductive technology (ART) leads to great relief for couples nowadays.
Methods: Present study was a retrospective study conducted at K.E.M hospital, a major tertiary care hospital after approval of the institutional ethics committee. A retrospective analysis of maternal and perinatal outcome of 30 cases of ART conception from the year 2014 to 2018 was done.
Results: The mean age of women enrolled into present study was 37.6 years and most common age group was 30-50 years. The main cause of infertility was unexplained (40%), other causes were female factor (33.33%), male factor (16.67%) and combined (10%). 63.33% pregnancies were singleton and 36.67% twin gestations. The most common complication seen was preterm labour (43.33%). The other complications were preeclampsia/eclampsia (33.33%), gestational hypertension, renal failure, gestational diabetes, cardiomyopathy, hepatic failure, HELLP syndrome and DIC. 60% patients had caesarean section and 40% had vaginal delivery.90.24% neonates had 5-minute Apgar score of more than or equal to 7 and 9.76% had score less than 7. There were 4 stillbirths accounting for 9.76% and out of live births,75.68% babies required NICU admission. There were 5 neonatal deaths (12.2%) and perinatal death rate was 21.95%.
Conclusions: ART is associated with a variety of maternal and perinatal complications. Couples should therefore be counseled about these risks while offering them ART as a mode of conception.
Metrics
References
Farquhar C, Marjoribanks J. Assisted reproductive technology: an overview of Cochrane Reviews. Coch Databas Systemat Revi. 2018(8).
Yang X, Li Y, Li C, Zhang W. Current overview of pregnancy complications and live-birth outcome of assisted reproductive technology in mainland China. Fertil Steril. 2014;101(2):385-91.
Wang AY, Safi N, Ali F, Lui K, Li Z, Umstad MP, et al. Neonatal outcomes among twins following assisted reproductive technology: an Australian population-based retrospective cohort study. BMC Pregnancy Childbirth. 2018;18(1):320.
Göçmen A, Güven Ş, Bağci S, Çekmez Y, Şanlıkan F. Comparison of maternal and fetal outcomes of IVF and spontaneously conceived twin pregnancies: three year experience of a tertiary hospital. Int J clinic Exp Med. 2015;8(4):6272.
Saccone G, Zullo F, Roman A, Ward A, Maruotti G, Martinelli P, et al. Risk of spontaneous preterm birth in IVF-conceived twin pregnancies. J Mater Fetal Neonatal Med. 2019;32(3):369-76.
Luke B, Stern JE, Kotelchuck M, Declercq ER, Anderka M, Diop H. Birth outcomes by infertility treatment: analyses of the population-based cohort Massachusetts outcomes study of assisted reproductive technologies (MOSART). J Reprod Med. 2016;61(3-4):114.
Jie Z, Yiling D, Ling Y. Association of assisted reproductive technology with adverse pregnancy outcomes. Iranian J Reprod Med. 2015;13(3):169.
Zhu L, Zhang Y, Liu Y, Zhang R, Wu Y, Huang Y, et al. Maternal and live-birth outcomes of pregnancies following assisted reproductive technology: a retrospective cohort study. Scient Reports. 2016;6:35141.
Gao L, Yang S. Perinatal outcomes of children born after assisted reproduction technology: A review. Austin J Reprod Med Infertil. 2015;2(5):1025.
Pinborg A, Wennerholm UB, Romundstad LB, Loft A, Aittomaki K, Söderström-Anttila V, et al. Why do singletons conceived after assisted reproduction technology have adverse perinatal outcome? Systematic review and meta-analysis. Human Reprod Update. 2012;19(2):87-104.
McLernon DJ, Harrild K, Bergh C, Davies MJ, De Neubourg D, Dumoulin JC, et al. Clinical effectiveness of elective single versus double embryo transfer: meta-analysis of individual patient data from randomised trials. BMJ. 2010;341:c6945.
American academy of pediatrics and American heart association. Textbook of neonatal resuscitation, 6th ed. Elk Grove Village, In: American academy of pediatrics and American heart association. 2011.
The Apgar score. Committee Opinion No. 644. American college of obstetricians and gynecologists. Obstet Gynecol. 2015;126:e52-5.
Daniel Y, Ochshorn Y, Fait G, Geva E, Bar-Am A, Lessing JB. Analysis of 104 twin pregnancies conceived with assisted reproductive technologies and 193 spontaneously conceived twin pregnancies. Fertil Steril. 2000;74(4):683-9.
Pourali L, Ayati S, Jelodar S, Zarifian A, Andalibi MS. Obstetrics and perinatal outcomes of dichorionic twin pregnancy following ART compared with spontaneous pregnancy. Int J Reprod Bio Med. 2016;14(5):317.
Caserta D, Bordi G, Stegagno M, Filippini F, Podagrosi M, Roselli D, et al. Maternal and perinatal outcomes in spontaneous versus assisted conception twin pregnancies. European J Obstet Gynecol Reprod e Biol. 2014;174:64-9.
Chughtai AA, Wang AY, Hilder L, Li Z, Lui K, Farquhar C, et al. Gestational age-specific perinatal mortality rates for assisted reproductive technology (ART) and other births. Human Reprod. 2017;33(2):320-7.