Risk Analysis And Mode Of Delivery Of Twin Pregnancy After IVF-ET

Objective: To analyzed the risk of twin pregnancy after IVF-ET and compare the clinical effect and safety for different methods of delivery.Methods:Part One:Retrospective analysis was conducted in the pregnancy after IVF-ET (group A was 106 twin cases and group B was 148 singleton cases among them)who chose to delivery in the 174th hospital from March to December in 2013 and the spontaneous pregnancy (group C was 54 twin cases and group D was 122 singleton cases by random sampling among them). By comparing the IVF-ET pregnancy and in spontaneous pregnancy (1) the incidence of maternal' complications (gestational diabetes mellitus, hypertensive disorders complicating pregnancy, prenatal anemia, placenta previa, placental abruption, fetal distress, premature rupture of membranes, postpartum hemorrhage);(2) the rate of the late threatened abortion and preterm labor; (3)the newborn's average weight when they were born,l minute after birth Apgar score, the incident of low birth weight,neonatal asphyxia and who were transfered into NICU;(4) postpartum hemrrhage after cesarean delivery and vaginal delivery.Part Two:Clinic dates were analyzed prospectively of 122 twin pregnancy women after IVF-ET who checked in regular in prenatal and delivering,who were term, first-timer, first-born as head presentation, full of membranes after IVF-ET operative pregnant women from January to December 2014 in our hospital, and analyzed the effect of 15 cases (balloon induced labor group)who using double balloon catheter to promote cervical mature and induced labor, and compared the mothers' and babies' outcome of it with oxytocin induced labor of 17 cases (oxytocin induced labor group), refused trial-produce and chose cesarean section 41 cases (choose cesarean sections) and natural labor in 49 cases (natural labor group).Results:In the complications of maternal,? the incidence of postpartum hemrrhage, hypertensive disorders complicating pregnancy and Prenatal anemia in group A were higher than those of group C, there would be statistical significance in the comparison groups(P<0.05);? the incidence of postpartum hemorrhage in group B were higher than those of group D, there would be statistical significance in the comparison groups(P<0.05);? the incidence of postpartum hemrrhage, hypertensive disorders complicating pregnancy and Prenatal anemia in group A were higher than those of group B, there would be statistical significance in the comparison groups(P<0.05)The rate of the late threatened abortion and preterm labor in group A were higher than group B, and the incident of preterm labor in 32-33+6 weeks and 34-36+6 weeks had the same results, there would be statistical significance in the comparison groups(P<0.05); (3)The rate of neonatal asphyxia and who were transfered into NICU in group A were higher than group B, there would be statistical significance in the comparison groups(P<0.05); (4)the cesarean section rate in group A was higher than that in group B, there would be statistical significance in the comparison groups(P<0.05); the cesarean section rate in group B was higher than that in group D, there would be statistical significance in the comparison groups(P<0.05); Division group A into two groups, including cesarean delivery group whose postpartum hemorrhage rate was 27.8% and natural birth group whose postpartum hemorrhage rate was 18.5%, there would be no statistical significance in the comparison groups, but the amount of postpartum hemorrhage in cesarean delivery group were higher than natural birth group, there would be statistical significance in the comparison groups(P<0.05).The vaginal delivery rate of balloon induced labor group was 80%, at the same time that of oxytocin induced labor group was 58.8% and that of natural labor group was 44.9%.The active phase (4-10cm)of balloon induced labor group was shorter than oxytocin induced labor group and natural labor group,(P<0.05), the time of induced labor and the time from labor to fetal childbirth time were both shorter than oxytocin induced labor group (P<0.05),birth weight was higher than natural labor group(P<0.05), and the amount of postpartum haemorrhage in 2 hours was less than oxytocin induced labor groups (P<0.05).Conclusions:IVF-ET pregnancy have more pregnancy complications and high cesarean section rate. Prevent and treat pregnancy complications actively, advocate the single blastocyst transplant, Reasonably choose the method of delivery and induced labor, which can improve the outcome of perinatal.