Maternal And Neonatal Outcome In Twin Pregnancies Conveived Spontaneously Versus Via Vitro IVF/ICSI

Objective:To compare the maternal and neonatal outcome in twin pregnancies conveived via vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)versus spontaneous twins pregnancies and to find out the special characters of human assisted reproductive techniques(ART)to guide clinical obstetric management and ensure the safety of ART.Methods:A total 173 twins pregnancies who had accomplished 28weeks's gestation at least,delivered in the Dalian gynaecology and obstetrics hospital between Jan,2015 and Jun,2016,,are retrospectively taken into this study.The puerperants were divided into two groups on account of the fertilization method,conveived spontaneously(n= 112)and in IVF/ICSI(n=61).Stillbirth,fetal reduction,abortion and induce labour because of deformity twin pregnancies had been eliminated.The basic personal information,main complications of the whole pregnant procedure and neonatal outcome data were collected and analyzed.The diagnostic criteria of premature birth,hypertensive disorder complicating pregnancy,gestational diabetes mellitus,intrahepatic cholestasis of pregnancy,placenta previa,placental abruption,premature rupture of membrane and fatal growth restriction or selective IUGR refer to the eighth edition of bstetrics and Gynecology.Result:The mean maternal age,percentages of primipara and caesarean section were significantly higher in the.group of IVF/ICSI(p<0.05).The gestational weeks of IVF/ICSI group was slightly longer than the spontaneously conveived group,but held statistical differences(P<0.05).In the complication perspectives,the incidence rates of premature birth and fatal growth restriction(FGR)or selective FGR especially were lower in the IVF/ICSI group(p<0.05)and the percentage of monochorionic diamniotic twins was obviously lower in the IVF/ICSI group(p<0.05).In the field of dichorionic diamniotic twins,there are differences in gestational diabetes mellitus,premature rupture of membranes,battledore placenta and cord andvelamentous insertion(P<0.05).As for neonatal outcome,the IVF/ICSI group's rate of entering NICU was lower than the other group and so were the levels of low birth weight and very low birth weight.Conclusion:The results above provided the evidence to prove that the ART itself fails to increase the incidence of obstetric complications and it will decrease the incidence of FGR and premature birth because of lack of monochorionic diamniotic twins.But it will lead to arising more negative neonatal outcome associated with low birth weight.And more maternal care from doctors and families will prolong the period of pregnancy,and increase the rate of caesarean section,however.