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Geburtshilfe Frauenheilkd 2014; 74(10): 933-939
DOI: 10.1055/s-0034-1383148
Original Article
GebFra Science
Georg Thieme Verlag KG Stuttgart · New York

Impact of Conception Method on Twin Pregnancy Course and Outcome

Auswirkungen der Konzeptionsmethode auf Verlauf und Ergebnis von Zwillingsschwangerschaften
S. Andrijasevic
1   Clinic of Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
,
J. Dotlic
2   Clinic of Obstetrics and Gynecology, Clinical Center of Serbia, Medical Faculty, University of Belgrade, Belgrade, Serbia
,
S. Aksam
1   Clinic of Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
,
J. Micic
2   Clinic of Obstetrics and Gynecology, Clinical Center of Serbia, Medical Faculty, University of Belgrade, Belgrade, Serbia
,
M. Terzic
2   Clinic of Obstetrics and Gynecology, Clinical Center of Serbia, Medical Faculty, University of Belgrade, Belgrade, Serbia
› Author Affiliations
Further Information

Publication History

received 24 April 2014
revised 01 September 2014

accepted 12 September 2014

Publication Date:
27 October 2014 (online)

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Abstract

Objective: The aim of the study was to investigate the course and outcomes of twin pregnancies conceived by different methods of assisted reproduction (ART) compared to those conceived spontaneously. Methods: The study involved patients with twin pregnancies who delivered at the Ob/Gyn Clinic of the Clinical Center of Serbia over a period of three years. Patients were differentiated according to method of conception and type of ART. Age, parity, etiology of infertility, pregnancy complications, time of membrane rupture and type of delivery was recorded for each patient. Gestational week at delivery, presentation, birth weight, Apgar score, chorionicity and accompanying disorders were separately recorded for each twin. The data were analyzed statistically. Results: A total of 431 patients were included in the study. Although more twins were conceived by ART, the difference was not statistically significant (p = 0.092). The most common ART procedure was IVF/ICSI (p = 0.001). ART procedures, particularly IVF/ICSI, were significantly correlated with more advanced maternal age, fewer previous pregnancies and delivery by cesarean sections, usually planned (p = 0.001). Preterm membrane rupture was more common after ICSI, but preterm delivery and pregnancy complications were infrequent, irrespective of the method of conception (p = 0.001). ART twins were mostly dichorionic (p = 0.036). Monochorionic twins were conceived either spontaneously or with ICSI. Conception by ART was not correlated with twinsʼ outcome (weight, Apgar score, disorders). Conclusions: ART procedures do not have a negative impact on twin pregnancy course and outcome. Twin pregnancies conceived spontaneously or by ART have similar outcomes.

Zusammenfassung

Zielsetzung: Die vorliegende Studie untersucht den Verlauf und die Ergebnisse von Zwillingsschwangerschaften bei nach verschiedenen Methoden der assistierten Reproduktion (ART) konzipierten Zwillingen verglichen mit spontan konzipierten Zwillingen. Methoden: Patientinnen mit Zwillingsschwangerschaften, die in der Frauenklinik des Klinikums von Serbien innerhalb eines Zeitraums von 3 Jahren entbunden hatten, wurden in die Studie aufgenommen. Die Patientinnen wurden je nach Konzeptionsmodus und ART-Methode in verschiedene Gruppen eingeteilt. Alter, vorangehende Schwangerschaften, Gründe der Unfruchtbarkeit, Schwangerschaftskomplikationen, Zeitpunkt des Blasensprungs und Entbindungsmodus jeder Patientin wurden vermerkt. Gestationswoche bei der Geburt, Kindslage, Geburtsgewicht, Apgar-Werte, Chorionizität sowie Komorbiditäten wurden für jedes Neugeborene separat vermerkt. Die gewonnenen Daten wurden einer statistischen Analyse unterzogen. Ergebnisse: Insgesamt 431 Patientinnen nahmen an der Studie teil. Obwohl die Gruppe von ART-konzipierten Zwillingen größer war, war dieser Unterschied statistisch nicht signifikant (p = 0,092). Die am häufigsten verwendete Methode zur assistierten Reproduktion war IVF/ICSI (p = 0,001). ART-Verfahren, insbesondere IVF/ICSI, korrelierten signifikant mit höherem mütterlichem Alter, geringerer Anzahl vorangegangener Schwangerschaften und geplanter Sectio-Entbindung (p = 0,001). Vorzeitiger Blasensprung war häufiger nach ICSI, aber vorzeitige Entbindung sowie Schwangerschaftskomplikationen waren in allen Gruppen selten (p = 0,001). ART-konzipierte Zwillinge waren meist dichorial (p = 0,036). Monochoriale Zwillinge entwickelten sich entweder nach Spontankonzeption oder ICSI. Es gab keine Korrelation zwischen assistierter Reproduktion und Entwicklung der Zwillinge (Geburtsgewicht, Apgar-Werte, Morbidität). Schlussfolgerungen: ART-Verfahren haben keine negative Auswirkung auf Verlauf und Ergebnis von Zwillingsschwangerschaften. Die Ergebnisse für Zwillingsschwangerschaften nach Spontankonzeption bzw. ART sind gleichwertig.

Key words

assisted reproductive technology (ART) - pregnancy - spontaneous conception - pregnancy outcome - twins

Schlüsselwörter

assistierte Reproduktion - Schwangerschaft - Spontankonzeption - Ausgang der Schwangerschaft - Zwillinge
 

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