PurposeThe purpose of this study was to compare the sizes of the placenta and umbilical cord in women with natural pregnancy versus those undergoing in vitro fertilization (IVF).MethodsOverall, 1610 cases of uncomplicated single pregnancies with vaginal delivery at ≥ 37 weeks of gestation were included in this study. The patients were divided into two groups: natural pregnancy group (n = 1453) and IVF pregnancy not including intracytoplasmic sperm injection (ICSI) treatment (n = 157). The groups were compared in terms of gestational week, maternal age, parity, maternal weight gain, prepregnancy maternal BMI, infant weight at birth, infant head circumference, placental weight, cross section of the placenta, cross section of the umbilical cord, insertion site of the umbilical cord, and umbilical cord length. Stepwise selection and multivariate logistic regression were used for statistical analysis to correct the result as an independent factor.ResultsThere was no difference in the size of the placenta and umbilical cord between women with natural pregnancy and with IVF, but the incidence of velamentous insertion of the cord was significantly increased in women with IVF pregnancy (adjusted odd ratio [AOR] 1.72, 95% confidence interval [CI] 1.08–2.72, p = 0.026).ConclusionsAlthough there is no difference in placental weight and cord size, velamentous insertion of the umbilical cord increases in IVF pregnancy and needs careful observation during the delivery process.
BackgroundEctopic pregnancy (EP) occurs in 1% of pregnancies and is reported to be more common in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) pregnancies. An abdominal ectopic pregnancy (AEP) is a rare form of EP, and there are few reports of an AEP after IVF/ICSI. In this case report, a rare case of AEP after frozen-thawed cycle of ICSI is presented.Case presentationAfter a frozen-thawed cycle of ICSI, the beta-human chorionic gonadotropin (HCG) level at 4 weeks 0 days of gestation was 3.4 IU/L. Subsequent dysfunctional uterine bleeding was mistaken for menstruation; however, an AEP of 9 weeks with a fetal heart beat was observed by ultrasound. After the AEP was observed by ultrasound, it was extracted laparoscopically.ConclusionA rare case of an AEP, which developed after frozen-thawed cycle of ICSI, presented with a very low serum HCG level. Even if the HCG titer is low, follow-up HCG levels and frequent medical examinations are necessary.
Background: To determine the risk factor for atonic bleeding in problem-free pregnancy.
BackgroundWe describe two cases of dichorionic triplet pregnancy after a frozen-thawed poor-stage embryo transfer.Main body of the abstractA 39-year-old and a 41-year-old woman underwent ART treatment. The first patient underwent intracytoplasmic sperm injection (ICSI) at 34 years of age, and two frozen-thawed poor-stage embryos were transferred at 39 years of age with assisted hatching, resulting in a trichorionic triamniotic triplet pregnancy. The second patient underwent ICSI, and two poor-grade blastocysts were transferred followed by assisted hatching, resulting in a dichorionic triamniotic triplet pregnancy.In the first case, the heartbeat of one monozygotic twin fetus had stopped on day 48 post-transfer (9 weeks 2 days), resulting in a dichorionic diamniotic twin pregnancy. A healthy boy and girl were delivered by elective caesarean section at 36 weeks, 5-days gestation. In the second case, the patient underwent selective reduction of the monochorionic twins, resulting in a single pregnancy that was vaginally delivered without any problems at 38 weeks 0-days gestation.Short conclusionsNumerous factors may be associated with the development of a monochorionic pregnancy; however, controversies still remain. The present morphological grading for embryos is insufficient for inhibiting the development of a monochorionic pregnancy.
Purpose of investigation:To compare the need for medical assistance during singleton deliveries between in vitro fertilization (IVF) pregnancy and spontaneous pregnancy (SP). Materials and Methods: A total of 848 women with singleton pregnancy (and who delivered at ≥ 36 weeks with problem-free pregnancy were divided into two groups. The groups were compared in terms of maternal age, parity, maternal pre-pregnancy body weight, maternal body weight at delivery, maternal weight gain, infant body weight, infant head circumference, and presence or absence of medical intervention (MI) at delivery (induction of labor, instrumental labor, or emergency cesarean section: CS). Results: The proportion of cases with MI was significantly higher in the IVF group (64.8%) than the SP group (39.3%). Clinical features, such as maternal age, parity, maternal body weight at delivery, infant body weight, and infant head circumference, were also extracted and compared between the two groups: MI group and non-medical intervention group. Univariate analysis showed significant differences between the MI group and the non-medical intervention group in terms of maternal age, maternal body weight at delivery, parity, infant body weight, infant head circumference, and presence or absence of IVF. Multivariate analysis of the factors that were significant in the univariate analysis showed similar trends in maternal age, parity, infant body weight, and presence or absence of IVF. In addition, the IVF group had a higher risk for requiring MI than the spontaneous pregnancy group [adjusted odds ratio (AOR) 1.74; 95% confidence interval (CI), 1.17-2.00, p < 0.01]. In particular, the IVF group had higher risk of needing emergency CS than the SP group (AOR 3.83; 95% CI, 1.87-7.78, p < 0.01). Conclusion: In spite of no problem in pregnancy course, the need for MI during labor increased after IVF regardless of maternal age and parity.
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