Kably AA, Campos CJA, Ortiz RH, Cevallos BJI, Monzalbo NDE

Language: Spanish
References: 9
Page: 188-192
PDF size: 71.75 Kb.

ABSTRACT

Background: High order pregnancies are more probable than singleton pregnancies in the use of assisted reproductive techniques. Since the 1980s there have been a higher number of multiple pregnancies. High order pregnancies are about 3% of all births, and are responsible for a high mortality rates in the mother and the fetuses.
Objective: To explain the outcome and perinatal outcome of pregnancies of high fetal order treated at the Angeles Lomas Hospital and its relationship with assisted reproductive techniques.
Material and methods: This is a retrospective study, analyzing all multiple pregnancies that took place in Angeles Lomas Hospital in Mexico throughout January 2005 to January 2010. Variables were diagnosis and time of infertility, age and the reproductive technique that was used. We analyzed gestational age at the moment of birth, Apgar scores in the first minute and five minutes, weight, newborns outcome and the obstetrical complications.
Results: We found a total of 35 multiple pregnancies that took place in the period of time studied. 22.8% were obtained by ovulation induction (n = 8), 5.7% by controlled ovarian hyperstimulation (n = 2), 8.57% by homologous artificial insemination (n = 3), 28.5% by IVF-ET/ICSI (n = 10), and 2.85% (n = 1) by a spontaneous pregnancy. The age range was 30.6 years (SD 4.27). In patients with IVF we observed an average of 3.75 transferred embryos, with a quality of 1.05. 100% of the newborns where delivered by cesarean section, the gestational age average was 31.6 weeks (SD 2.76), Apgar scores 7.9 (SD 1.15)/8.79 (SD 0.57), and average weight was 1,442 g (SD 422.65). We observed 3 deaths (8.57%). The main obstetrical complications were preeclampsia (11.42%, n = 4), fetal growth restriction (8.57%, n = 3), and gestational diabetes/premature rupture of membranes (5.71%, n = 2).
Conclusions: We observed a low rate of multiple birth in low complexity procedures (1.94%, homologous artificial insemination), and in high complexity procedures (3.75%). In our study the complication rate was not higher than what is reported in the literature, the new born outcome was generally good, with an 8.5% of mortality rate.

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