scholarly journals The Desire for Multiple Pregnancy among Patients with Infertility and Their Partners

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ida Lilywaty Md Latar ◽  
Nuguelis Razali
Keyword(s):  
Multiple Pregnancy ◽  
Previous Treatment ◽  
Multiple Pregnancies ◽  
Singleton Pregnancy ◽  
Increased Risk ◽  
Fetal Complications

Objective. To study the predictors for desire for multiple pregnancies and the influence of providing information regarding the maternal and fetal complications associated with multiple pregnancies on their preference for multiple pregnancies.Methods. Couples attending an infertility clinic were offered to fill up a questionnaire separately. Following this, they were handed a pamphlet with information regarding the risks associated with multiple pregnancies. The patients will then be required to answer the question on the number of pregnancies desired again.Results. Two hundred fifty three out of 300 respondents completed the questionnaires adequately. A higher proportion of respondents, 60.3% of females and 57.9% of males, prefer singleton pregnancy. Patients who are younger than 35 years, with preexisting knowledge of risks associated with multiple pregnancies and previous treatment for infertility, have decreased desire for multiple pregnancies. However, for patients who are older than 35, with longer duration of infertility, and those patients who have preexisting knowledge of the increased risk, providing further information regarding the risks did not change their initial preferences.Conclusion. Providing and reinforcing knowledge on the risks to mother and fetus associated with multiple pregnancies did not decrease the preference for multiple pregnancies in patients.

Multiple pregnancy

2020 ◽  
pp. 253-267
Author(s):  
Surabhi Nanda ◽  
James P. Neilson
Keyword(s):  
Preterm Birth ◽  
Multiple Pregnancy ◽  
Multiple Pregnancies ◽  
Hypertensive Disorders Of Pregnancy ◽  
Maternal Complications ◽  
Singleton Pregnancy ◽  
Birth Complications ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Need Support

There has been a consistent rise in multiple pregnancies over recent years. Such pregnancies are at increased risk of miscarriage, fetal abnormalities, preterm birth, complications specific to shared placentation including twin-to-twin transfusion syndrome, selective growth restriction, and twin anaemia–polycythaemia sequence. In addition, a woman with a multiple pregnancy is at a higher risk of maternal complications including pre-eclampsia and other hypertensive disorders of pregnancy, obstetric cholestasis, gestational diabetes, exaggerated maternal pregnancy symptoms, and postpartum haemorrhage. Antenatal care in a multiple pregnancy should ideally be offered in a dedicated setting, with increased contact with the healthcare professionals compared to a singleton pregnancy. Such pregnancies, especially when complicated, need support and appropriate counselling to prepare for an optimal outcome.

Prevalence and Forms of Congenital Anomalies in Twins Born in Pomeranian District During the Period from 1.07.1997 to 31.12.1998

1998 ◽  
Vol 47 (3-4) ◽  
pp. 255-259 ◽  
Author(s):  
T. Zimoń ◽  
M. Walczak ◽  
J. Fydryk ◽  
A. Materna-Kiryluk ◽  
J. Mejnar-towicz ◽  
...  
Keyword(s):  
Congenital Anomalies ◽  
Prevalence Rate ◽  
Congenital Malformations ◽  
Multiple Pregnancy ◽  
Multiple Pregnancies ◽  
Singleton Pregnancy

AbstractThe authors have analysed the frequency and structure of congenital anomalies in children born in the Pomeranian district in the period from 01.07.1997 to 31.12.1998. Among a total of 28.361 births in that area, 748 (2.64%) were affected by congenital anomalies. Among 28.361 births, 620 (2.18%) were from multiple pregnancies. 23 (3.71%) among births from multiple pregnancies were affected by congenital malformations. The prevalence rate of inborn anomalies in births from multiple pregnancy in our area were higher (3.71%) in comparison to births from singleton pregnancy (2.61%). It implies that children born from multiple pregnancy are at higher risk of developing congenital anomalies.

scholarly journals Antenatal fetal death in multiple pregnancy: is early prediction possible?

2021 ◽  
Vol 14 (6) ◽  
pp. 602-611
Author(s):  
V. I. Tsibizova ◽  
D. V. Blinov ◽  
V. O. Bitsadze ◽  
T. M. Pervunina ◽  
E. V. Komlichenko ◽  
...  
Keyword(s):  
Perinatal Mortality ◽  
Reference Values ◽  
Fetal Death ◽  
Multiple Pregnancy ◽  
First Trimester ◽  
Multiple Pregnancies ◽  
Vitro Fertilization ◽  
Diagnostic Potential ◽  
Increased Risk

Introduction. Perinatal mortality in multiple pregnancies increases by 8–10 times compared to singletons. Stillbirth is a significant part of all complications of multiple pregnancies. Although the incidence of perinatal mortality in multiple pregnancies has decreased consistently compared to extremely high rates in the past, it remains relatively high, despite significant positive changes in the management of such pregnancies. Aim: to assess the diagnostic potential of the first trimester's biochemical screening in multiple pregnancies for predicting antenatal fetal death. Materials and Methods. As part of a retrospective study, a cohort of twin pregnancies after in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), or spontaneous conception underwent screening of the first trimester at 11+0–13+6 weeks of gestation as recommended by the Fetal Medicine Foundation. Determination of pregnancy-associated plasma protein-A (PAPP-A) in blood serum with subsequent calculation of the relative PAPP-A MoM (multiples of median) – a multiple of the median (an indicator of how much the individual test result deviates from the reference values) was performed. Results. Prenatal screening and outcomes of 302 multiple pregnancies showed that with PAPP-A MoM < 0.5, antenatal fetal death occurred with a frequency of 42.86 % (6/14), with PAPP-A MoM within the reference values – In 12.67 % (28/221), with PAPP-A MoM > 2.0 – in 6.7 % (2/30). Differences between patients with PAPP-A MoM < 0.5 and PAPP-A MoM within the reference values, as well as PAPP-A MoM < 0.5 and PAPP-A MoM > 2.0 were statistically significant (p = 0.002 and p = 0.004, respectively). No differences were detected between spontaneous and assisted reproductive technology (ART) pregnancies. Conclusion. In women with multiple pregnancies resulting from ART or spontaneous, PAPP-A MoM values below the reference interval (< 0.5) in the first trimester are associated with an increased risk of antenatal fetal death.

scholarly journals Risks and challenges in multiple pregnancy

2021 ◽  
Vol 10 (12) ◽  
pp. 4578
Author(s):  
Aditi Agarwal ◽  
Arti Sharma ◽  
Neeta Bansal ◽  
Neha Panwar ◽  
Shweta Singh ◽  
...  
Keyword(s):  
Placenta Previa ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
Obstetric Care ◽  
Elevated Risk ◽  
Multiple Pregnancies ◽  
Triplet Pregnancy ◽  
Mother And Child ◽  
Fetal Complications ◽  
Fetal Malformations

Because of breakthroughs in reproductive medicine, multiple pregnancies have become more common in the industrialized world. As a result, obstetric care for women with multiple pregnancies and neonatal care for the same has become more demanding. Multifetal pregnancies are linked to an elevated risk for both the mother and child. There is increased incidence of obstetric complications such as spontaneous abortion, hypertensive disorders, placenta previa, and fetal malformations. Perinatal outcome is also affected which is attributable to increased incidence of fetal complications like prematurity, congenital malformations, growth discordance and cord accidents. We are presenting 2 cases, one of MCMA twin pregnancy with fetal congenital anomaly and another of a triplet pregnancy and their perinatal outcomes.

scholarly journals MULTIPLE PREGNANCY, ANTENATAL CARE PROBLEMS AND THEIR SOLUTIONS RESULTS

2017 ◽  
Vol 1 ◽  
pp. 39-45
Author(s):  
Iryna Nikitina ◽  
Natalya Kalashnyk ◽  
Svitlana Smiian ◽  
Tatyana Babar ◽  
Alina Popova
Keyword(s):  
Transvaginal Ultrasound ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
Statistical Processing ◽  
Multiple Pregnancies ◽  
Perinatal Complications ◽  
Singleton Pregnancy ◽  
Monochorionic Twins ◽  
Pregnancy And Childbirth ◽  
Ultrasound Monitoring

Aim of the work. The aim of our study is to summarize the course of pregnancy and delivery in multiple pregnancies in modern conditions. Materials and methods. The analysis of the pregnancy course, labor and perinatal outcomes was carried out in 182 women with diochorionic and 86 patients with monochorionic twins and 40 women with a singleton pregnancy. Multiple pregnancies were proved to be a monochorionic (MH) and diochorionic (DH) that is a high risk factor for perinatal complications. The research included clinical and laboratory examination metods, study of hormonal function of fetoplacental complex (FPC), transvaginal ultrasound examination. Statistical processing of data was carried out using the package of applied programs Microsoft Office Excel 2010 and StatSoft Statistica 6.1. Results and discussion. In the analysis of pregnancy the abortion threat was detected in 51 (59.3%) women with monochorionic and 34 (62%) women with diochorionic twins. Preeclampsia during pregnancy complicated in 26 (30.2%) and 43 (23.6%) patients, with monochorionic and diochorionic placentation type, respectively. A frequent complication of both the MH and DH twins was anemia, which was found in more than half of the surveyed (56.9 and 51%, respectively). Delivery in the case of multiple pregnancies is also much more complicated and is terminated surgically three times more often than in singleton births. The most frequent indications for operative delivery were first breech fetus, fetal distress during pregnancy and childbirth, FGR, severe preeclampsia, premature detachment of normally situated placenta, anomalies of labor activity. These perinatal losses were equally observed both after cesarean section and after spontaneous labor and amounted to 4% at monochorionic and 1.7% at diochorionic twins. The frequency dependence of identified lesions at pregnancy with twins was established by chorionic. Careful observation of the patients with multiple pregnancies in the antenatal period, the prevention of the most frequent complications, ultrasound monitoring of early pregnancy allows a differentiated approach to the management of pregnancy and childbirth, helping to reduce perinatal morbidity and mortality. Conclusions. Multiple pregnancies occur with a large number of complications compared with singletons. Thus, the increase of frequency of multiple pregnancy influences the obstetric and perinatal indicators, pushing this issue in a number of the most pressing issues of modern obstetrics and perinatology.

P–668 We aim for one baby, not one embryo: a personalized ET strategy based on embryo score and woman age maximizes LB and minimizes twins

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Pujol ◽  
O Cairó ◽  
T Mukan ◽  
V Pérez ◽  
D García ◽  
...  
Keyword(s):  
Live Birth ◽  
Twin Pregnancy ◽  
Multiple Pregnancy ◽  
Time To Pregnancy ◽  
Birth Rates ◽  
Twin Birth ◽  
Live Birth Rates ◽  
Embryo Score ◽  
Increased Risk ◽  
Fetal Complications

Abstract Study question Is it possible to define a personalized ET model to maximize the chance of live birth (LB) while minimizing the risk of twin pregnancy? Summary answer A model including age and embryo morphological score can inform a personalized ET strategy to maximize LB while minimizing the risk of twin pregnancy. What is known already The morphological score of the transferred embryos affects pregnancy (PR) and LB rates in IVF cycles. Although SET is mainly recommended to avoid multiple pregnancies, DET is still being performed extensively, especially in patients with poor prognosis, with the aim to improve PR per transfer and shorten time to pregnancy. While twin pregnancies are associated with an increased risk of maternal and fetal complications, very low PR may increase patient drop-off, extend time to pregnancy, and increase the cost per successful transfer. A personalized transfer strategy balancing high LB per transfer with low twin pregnancy rates should be defined. Study design, size, duration Retrospective study including 2,470 fresh and frozen embryo transfers (ET) of either one or two embryos at D3 from January 2016 to August 2019 in a single IVF clinic. Biochemical, clinical, multiple pregnancy and live birth rates after SET and DET were analyzed according to the morphological score of the embryos transferred. ETs were divided into 9 groups according to the combinations of their embryo morphological scores. Participants/materials, setting, methods Embryos were assessed on D3 following a national recommended morphological scale. Morphology was categorized as High (H) if A or B+, medium (M) if B or C+, and Low (L) if C or D. The likelihood of biochemical, clinical pregnancy and live birth, and the risk of multiple pregnancy, after SET and DET of embryos of different scores was analyzed. A logistic regression analysis adjusted by age of the woman was ran for each outcome. Main results and the role of chance The distribution of ETs among the 9 groups for SET was: 510 H, 715 M, 346 L; for DET: 142 HH, 148 HM, 29 HL, 268 MM, 164 ML, 148 LL. Mean woman age was similar among groups: 38.7±4.01. Live birth and twin rates increased with embryo score. Considering a SET of category M as reference, the OR of live birth in DET were: 2.76 [1.82, 4.19 95%CI] for HH, and 2.32 [1.51, 3.55 95%CI] for HM, and 1.69 [1.19, 2.40 95%CI] for MM, and in SET: 1.52 [1.12, 2.04 95%CI] for H. Considering a DET of category MM as reference, the OR of twin birth in DET were: 2.8 [1.14, 6.99 95%CI] for HH, 2.5 [0.98, 6.46 95%CI] for HM, and 0.92 [0.11, 7.84 95%CI] for HL. According to this model, a 38y.o. woman with a SET of category M would have a 16% chance of live birth, and no twins. The addition of an M (DET: MM) increases her chance of live birth to 24% with a 2.9% risk of twins. The addition of a H (DET:MH) would increase further her chance of live birth to 30.8%, however, the increase would be due almost exclusively to twins (7%). Limitations, reasons for caution The limitations of this study are its retrospective nature and the small size of some categories. Embryos were classified using a national morphological scale; other morphological classifications could influence the results. The development and validation of site-specific models, using local patients’ data, is recommended before their use in clinical practice. Wider implications of the findings: A personalized assessment of embryo quality and woman age, at a minimum, are necessary to identify the best ET strategy for each patient; this strategy allows to maximize live birth rates while keeping the risk of twin birth as low as possibl. Trial registration number Not applicable

scholarly journals Study of Fetal Neurodevelopment in Multiple Pregnancies

2009 ◽  
Vol 3 (3) ◽  
pp. 51-60
Author(s):  
Guillermo Azumendi ◽  
Sejfulah Perva ◽  
Ingrid Marton ◽  
Madeeha Al-Noobi
Keyword(s):  
Cerebral Ischemia ◽  
Preterm Delivery ◽  
Gestational Age ◽  
Congenital Anomalies ◽  
Multiple Pregnancies ◽  
Singleton Pregnancy ◽  
Increased Risk ◽  
Periventricular Hemorrhage ◽  
Singleton Pregnancies

Abstract According to many reports multiple pregnancies compared to singelton have a 5-10 fold increased risk for CP and some of increased risk is due to the risk of preterm delivery, no mater whether, it mono or dizygotic conception. In those cases CP is most probably complication of peripartal periventricular hemorrhage or leukomalacia. Known fact about twins is that the lower is the gestational age at the time of delivery, the probability that they are monozygotic is greater. Monochorionic multiple pregnancies and feto-fetal hemodynamic transfusion instability are leading to cerebral ischemia. For all of mentionable reasons monozygotic multiple pregnancies have a greater risk of cerebral impairment. CP in an apparently singleton pregnancy could be associated with a “vanishing” twin phenomenon. There are reports that some of the congenital anomalies in apparently singleton pregnancies may be associated with the unrecognized or unrecorded loss of a co-twin. It has been established that ART conceptions are at a greater risk of CP because of the greater risk of preterm delivery. There have been many attempts to minimize CP prevalence by reduction of number of fetuses in a multifetal ART pregnancy but without affect, most probably because the majority of ART conceptions are dizygotic.

scholarly journals Obstetric Outcome in Adolescents-(A Single Centre Experience Over 10 Years from Jan 2006-Dec 2015)

2021 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Multiple Pregnancy ◽  
Tertiary Hospital ◽  
Age Group ◽  
Adult Group ◽  
Single Centre ◽  
Singleton Pregnancy ◽  
Royal Hospital ◽  
Gestation Age ◽  
Increased Risk ◽  
Single Centre Experience

The aim of this study is to determine whether young adolescents aged 11-19 years have an increased risk of cesarean or operative delivery, as well as maternal or neonatal delivery-related morbidity, compared to young adults aged 20- 24 years in the tertiary hospital Royal Hospital in period from January 2006 to December 2015. It is a retrospective cohort study and we include all women delivered in royal hospital in that period of time and aged from 14 to 25 years and gestational age more than 24 week’s singleton pregnancy and cephalic presentation during labour. We exclude maternal Age > 25 years and Gestation age ≤24 weeks, Non-cephalic presentation and Multiple pregnancy. By this study, there is no significant outcome complication among adolescent age group pregnancy compare to adult group except IUGR and NICU admissions.

scholarly journals Recovery of second trimester pre-eclampsia after fetal reduction of a triplet

2019 ◽  
Vol 12 (9) ◽  
pp. e227667
Author(s):  
Jeske M bij de Weg ◽  
Christianne J de Groot ◽  
Eva Pajkrt ◽  
Marjon A de Boer
Keyword(s):  
Severe Hypertension ◽  
Multiple Pregnancy ◽  
Second Trimester ◽  
Multiple Pregnancies ◽  
Review Of The Literature ◽  
Hypertensive Disorders Of Pregnancy ◽  
Triplet Pregnancy ◽  
Increased Risk ◽  
Multifetal Pregnancy ◽  
Multifetal Pregnancy Reduction

Women with a multiple pregnancy are at increased risk of developing hypertensive disorders of pregnancy. We describe a case of a dichorionic triamniotic triplet pregnancy complicated by severe hypertension, proteinuria and maternal symptoms, fitting with the diagnosis of pre-eclampsia, apart from the early gestational age of only 16 weeks. After reduction of the monochorionic pair, the disease resolved and pre-eclampsia was diagnosed again at 30 weeks of gestation, resulting in a delivery on maternal indication at 33 weeks of gestation. In a review of the literature, we found six papers including eight cases on multifetal pregnancy reduction on maternal indication. Multifetal pregnancy reduction resulted in a prolongation of pregnancy of two to 21 weeks and may be considered in extreme early onset pre-eclampsia in dichorionic multiple pregnancies.

Management and outcome of high-order multiple pregnancy

1996 ◽  
Vol 8 (3) ◽  
pp. 133-142
Author(s):  
Shlomo Lipitz ◽  
Dan Grisaru ◽  
Zeev Rotstein ◽  
Reuwen Achiron
Keyword(s):  
Multiple Pregnancy ◽  
Neonatal Morbidity ◽  
High Order ◽  
Multiple Pregnancies ◽  
Maternal Complications ◽  
Vitro Fertilization ◽  
Increased Risk ◽  
High Prevalence ◽  
Need To Evaluate

The incidence of pregnancies with three or more fetuses has markedly increased over the past two decades. The change has been attributed to the introduction and widespread use of new techniques for ovulation induction and placement of multiple embryos during in vitro fertilization (IVF). These techniques have been a matter of concern, since triplet and higher multiple pregnancies have long been associated with an increased risk of maternal complications, and a high prevalence of perinatal and neonatal morbidity and mortality. Furthermore, the developing experience with multifetal pregnancy reduction offers a new option for the management of these pregnancies. There is therefore a need to evaluate the management and outcome of high-order multiple pregnancies.

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