Outcomes of multifetal pregnancies

Kor-anantakul, Ounjai; Suwanrath, Chitkasaem; Suntharasaj, Thitima; Getpook, Chatpavit; Leetanaporn, Roengsak

doi:10.1111/j.1447-0756.2007.00477.x

Cited by 13 publications

(6 citation statements)

References 24 publications

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“…In this regard, our results are in contrast to those of other reports [1,10,13,25,29,33,34,36,42]. One study described a higher rate of elective surgical delivery [44], and three other studies report a higher rate of Caesarean section, in addition to prematurity and prematurity-related neonatal complications for ART twins [4,20,25]. In addition, the rate of Caesarean section observed in another German study differs markedly between ART (76.2 %) and SC (42.5 %) twins [16].…”

Section: Caesarean Sectioncontrasting

confidence: 97%

“…We could not find any significant differences with regard to prematurity between our ART group (50 %) and our SC group (48.2 %). This is again in contrast to previous studies which described an increased frequency of prematurity in their ART twin collectives [4,8,10,13,17,20,21,25,27,29,33,34,36,38,41,45]. Reddy et al [31] reported that more than one half of all neonates are the products of multifetal gestations that are accompanied by an increase of prematurity complications.…”

Section: Prematuritycontrasting

confidence: 74%

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Twin Pregnancies Conceived Spontaneously and by ART (Assisted Reproductive Technologies) – a Retrospective Analysis and Review

Lehnen¹,

Schäfer²,

Reineke³

et al. 2011

Geburtsh Frauenheilk

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Purpose: The aim of this study was to compare the perinatal and maternal outcome of our own cohort of twin pregnancies after IVF/ICSI and spontaneous conception to the respective available standards and findings in the current literature. Material and Methods: Perinatal and maternal data of 305 twin pregnancies conceived spontaneously and 74 pregnancies conceived by IVF/ICSI were compared. The following parameters were examined: maternal age, first parity, gestational age, Caesarean section rate, birth weight, sex constellation, umbilical arterial blood pH of the first and second child, maternal complications, fetal malformations, perinatal and neonatal mortality. These data were tested by retrospective statistical analysis (Fisher exact test, Wilcoxon Rank Sum Test). In addition, these parameters were also evaluated separately in dichorionic/diamniotic twins and monochorionic/diamniotic twins. Results: We found significant differences with higher maternal age, higher rate of first parity, an increased incidence of pre-eclampsia and a lower rate of SGA (VLBW) in the ART group and ART subgroup (di/di) compared to the SC group. Caesarean section rate, birth weight, arterial pH of the first and second twin, prematurity, rate of malformations, perinatal and neonate mortality, respectively, were not significantly different between the two groups. For prematurity < 37 weeks of gestation, a significantly higher frequency of the male/male sex constellation was observed. Conclusion: Actually, we are now able to more specifically counsel women conceiving by IVF/ICSI concerning maternal and perinatal outcome. Zusammenfassung! Fragestellung: Ziel der Studie ist der Vergleich zwischen dem perinatologischen und maternalen Outcome unserer eigenen Zwillingsschafts-Kohorte nach ART (IVF/ICSI) und spontaner Konzeption (SC) im Vergleich zu den verfügbaren Standards und Suchergebnissen der vorhandenen Literatur. Material und Methoden: Verglichen wurden die perinatalen und maternalen Daten von 305 spontan konzipierten Zwillingsschwangerschaften zu 74 Geminigraviditäten nach IVF/ICSI. Die folgenden Parameter wurden untersucht: mütterliches Alter, Erstparität, Schwangerschaftwoche, Sectiorate, Geburtsgewicht, Geschlechtskonstellation, arterieller Nabelschnur-pH des 1. und 2. Kindes, maternale Komplikationen, fetale Fehlbildung, perinatale und neonatale Mortalität. Diese Daten wurden einer retrospektiven statistischen Analyse mittels Fisher-Exact-Test, Wilcoxon-Rangsummen-Test unterzogen. Weiterhin wurden diese Daten nach Dichorializität/Diamnializität und Monochorializität/Biamnializität aufgeschlüsselt. Ergebnisse: Wir fanden signifikante Differenzen mit höherem maternalen Alter, höherer Rate von Erstparität und einer ansteigenden Inzidenz von Präeklampsie sowie eine niedrigere Rate von SGA (VLBL) in der ART-Gesamtgruppe und ART-Subgruppe (Dichorializität/Diamnializität) im Vergleich zur SC-Gruppe. Die Sectiorate, das Geburtsgewicht, der umbilikale arterielle pH des 1. und 2. Zwillings, Frühgeburtlichkeit, Malformationsrate, perinatal...

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Section: Caesarean Sectioncontrasting

confidence: 97%

Section: Prematuritycontrasting

confidence: 74%

Twin Pregnancies Conceived Spontaneously and by ART (Assisted Reproductive Technologies) – a Retrospective Analysis and Review

Lehnen¹,

Schäfer²,

Reineke³

et al. 2011

Geburtsh Frauenheilk

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“…3 Twin pregnancies are risk factors during pregnancy as they result in preterm deliveries and are frequently associated with medical complications like preeclampsia, gestational diabetes and antepartum haemorrhage. 2,4,5 Multiple pregnancies also result in poor perinatal outcome due to complications in babies like prematurity, low birth weight, growth restriction and congenital anomalies. Optimizing maternal, fetal and perinatal outcome is definitely a hurdle to be crossed in obstetrics, hence the need for further such studies.…”

Section: Introductionmentioning

confidence: 99%

Maternal determinants and fetal outcome of twin pregnancy: a five-year survey

Mathew

Wills

Abraham

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Study prevalence of twin pregnancy, maternal risk factors and fetal outcome in twin pregnancy.Methods: A retrospective study of mothers with twin pregnancies who delivered during the period of 5 years. There were 109 mothers who gave birth to 218 babies. Maternal details, antenatal complications and fetal outcomes were analysed.Results: There were 5432 deliveries which included 109 twin births. Prevalence of twinning was 20/1000 deliveries. The mean age was 28.11 (±SD 4.89) with 69.7% in the younger age groups. No association with parity, BMI and ovulation induction was found. Most common complication was preterm delivery (64.2%) with mean gestational age being 35.07 (±SD 2.32). Others were diabetes (25.7%), hypertension (22.9%), hypothyroidism (14.6%) and postpartum hemorrhage (13.7%). Cesarean section was the commonest mode of delivery (78.0%) with fetal malpresentation (26.6%), fetal distress (20.2%) and hypertension (12.0%) being the commonest indications for termination. Among the hypertensive mothers, 23 delivered by Cesarean and only 2 delivered vaginally which was statistically significant (p- 0.03 OR 5.20). Dichorionicity was commoner than monochorionicity (66.1% vs. 33.9%). Among 218 fetuses delivered, 214 were live births and 4 still born. There were low birth weight Babies (70.6%), normal weight (15.3%), VLBW babies (11.5%) and 2.7% ELBW babies. Fetal complications were IUGR (11.46%), discordant twins (6.8%), congenital anomalies (1.8%), single fetal demise (1.8%) and Intra uterine death of a twin (0.4%). Perinatal mortality rate was 1.65 per thousand births.Conclusions: Prevalence of twin pregnancy was 20/1000 deliveries. Twin pregnancies were seen to be more in the younger age group. Preterm labor, diabetes and hypertension were the main complications with cesarean the most common mode of delivery. Dichorionicity led to less fetal complications and low perinatal mortality.

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“…The dangers of carrying and delivering multiple fetuses, including a higher risk for prematurity and low birth weight, are well documented (Koranantakul et al 2007).…”

Section: Welfare and Global Surrogacymentioning

confidence: 99%

Global Surrogacy, Exploitation, Human Rights and International Private Law: A Pragmatic Stance and Policy Recommendations

Bromfield

Rotabi

2014

Glob Soc Welf

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The number of global surrogacy arrangements increased exponentially over the last decade, and the rise in the practice has led to concerns over issues such as social justice, exploitation, and human rights abuses. Currently, there are no international regulations or guidelines regarding global surrogacy arrangements, and in some countries where the practice is prevalent, i.e., India, there is limited national regulation or oversight. Global surrogacy is a complex issue that includes questions related to morality, parentage, the natural motherinfant bond, and the complexities of inequalities in a globalized world that interface with a multi-million dollar industry. The purpose of the paper is to present global surrogacy dynamics written in a manner to help the reader understand this complex phenomenon, including a discussion of the associated problems and ethical dilemmas. The USA and India, two contrasting global surrogacy destination countries, are presented as cases, and some unique matters related to surrogacy in each country are emphasized to highlight the issues. Human rights instruments and international private law are discussed to frame global surrogacy regulation including the rights of the child and the rights of women. The analysis is concluded with pragmatic policy recommendations oriented to some of the practices necessary to regulate global surrogacy arrangements in a fair and consistent manner, while maintaining that ultimately the voices of all involved in global surrogacy contracts, and most especially the surrogates themselves, need to be included in further discussions of the issue.

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Outcomes of multifetal pregnancies

Cited by 13 publications

References 24 publications

Twin Pregnancies Conceived Spontaneously and by ART (Assisted Reproductive Technologies) – a Retrospective Analysis and Review

Twin Pregnancies Conceived Spontaneously and by ART (Assisted Reproductive Technologies) – a Retrospective Analysis and Review

Maternal determinants and fetal outcome of twin pregnancy: a five-year survey

Global Surrogacy, Exploitation, Human Rights and International Private Law: A Pragmatic Stance and Policy Recommendations

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