scholarly journals Maternal characteristics and pregnancy outcomes of Chinese women with infertility undergoing assisted reproductive technology treatment:a retrospective cohort study

2020 ◽  
Author(s):  
Jingxue Wang(Former Corresponding Author) ◽  
Qiwei Liu ◽  
Boer Deng ◽  
Fang Chen ◽  
Xiaowei Liu ◽  
...  
Keyword(s):  
Male Infertility ◽  
Pregnancy Outcomes ◽  
Postpartum Haemorrhage ◽  
Chinese Women ◽  
Placenta Previa ◽  
Maternal Characteristics ◽  
Tubal Disease ◽  
Nicu Admission ◽  
Minute Apgar Score ◽  
Singleton Pregnancies

Abstract Background : To examine differences in the maternal characteristics and pregnancy outcomes of Chinese women with various causes of infertility who underwent assisted reproductive technology (ART) treatment. Methods: This retrospective cohort study included women with various causes of infertility who used ART. Data on demographic characteristics, medical history, laboratory tests, and delivery were reviewed. Logistic regression analysis was performed to calculate odds ratios and 95% confidence intervals for pregnancy and perinatal complications and neonatal outcomes. The multivariable model was adjusted for age, gravidity, parity, pre-pregnancy obesity, birth plurality , and history of previous caesarean section. Results: The ART treatment group was divided into 5 subgroups according to infertility cause as follows: ovulation disorder, tubal disease, male infertility , endometriosis, and mixed infertility . Among singleton pregnancies, compared with spontaneous pregnancies , ART pregnancies were associated with significant increases in the rates of the following: gestational diabetes mellitus (GDM), preeclampsia, preterm preeclampsia, postpartum haemorrhage , intrahepatic cholestasis of pregnancy , preterm premature rupture of membranes, preterm birth, low birthweight, macrosomia, and neonatal intensive care unit (NICU) admission in the ovulation disorder group; GDM, placenta previa, placenta accreta , postpartum haemorrhage, macrosomia and 5 -minute Apgar score ≤7 in the tubal disease group; placenta previa, a bnormal placental cord insertion , small for gestational age, macrosomia and NICU admission in the endometriosis group; placenta previa and placenta accreta i n the male infertility group; and GDM, placenta previa, placental abruption, chorioamnionitis, preterm birth , and 1-minute Apgar score≤7 i n the mixed infertility group. Among multiple pregnancies, most of the differences that were significant in singleton pregnancies were less extensive or had disappeared. Conclusions: During the perinatal period, maternal characteristics, in particular type of infertility, appears an additional risk factor for abnormal pregnancy outcomes besides use of IVF techniques. Lower risk is found in male infertility and higher risk for ovulation disorders.

scholarly journals Maternal characteristics and pregnancy outcomes of Chinese women with infertility undergoing in vitro fertilization  with  embryonic cryopreservation :  a retrospective cohort study

2020 ◽  
Author(s):  
jingxue wang ◽  
qiwei liu ◽  
Boer Deng ◽  
fang chen ◽  
xiaowei liu ◽  
...  
Keyword(s):  
Male Infertility ◽  
Pregnancy Outcomes ◽  
Chinese Women ◽  
Placenta Previa ◽  
Vitro Fertilization ◽  
Maternal Characteristics ◽  
Tubal Disease ◽  
Nicu Admission ◽  
Singleton Pregnancies

Abstract Background: To examine differences in the maternal characteristics and pregnancy outcomes of Chinese women with various causes of infertility who underwent in vitro fertilization (IVF) with embryonic cryopreservation treatment.Methods: Cases were pregnancies after IVF-ET with embryonic cryopreservation; controls were spontaneously conceived pregnancies. Subgroup analysis was carried out according to etiology of infertility. The IVF treatment group was divided into 5 subgroups according to infertility etiology as follows: ovulation disorder, tubal disease, male infertility, endometriosis, and mixed infertility. Data on demographic characteristics, medical history, laboratory tests, and delivery were reviewed. Logistic regression analysis was performed for pregnancy and perinatal complications and neonatal outcomes. The multivariable model was adjusted for potential confounders.Results: Among singleton pregnancies, compared with spontaneous pregnancies, IVF pregnancies were associated with significant increases in the rates of the following: gestational diabetes mellitus (GDM) (aOR 1.76[95% CI 1.33-2.33]), preeclampsia (2.60[1.61-4.20]), preterm preeclampsia (4.52[2.03-10.06]), postpartum hemorrhage (1.57[1.04-2.36]), intrahepatic cholestasis of pregnancy (3.84[1.06-13.94]), preterm premature rupture of membranes (2.11[1.17-3.81]), preterm birth (1.95[CI 1.26-3.01]), low birthweight (1.90[1.13-3.20]), macrosomia (1.53[1.03-2.27]), and neonatal intensive care unit (NICU) admission (1.69[1.22-2.34]) in the ovulation disorder group; GDM (1.50[1.21-1.86]), placenta previa (2.70[1.59-4.59]), placenta accreta (1.78[1.10-2.89]), postpartum hemorrhage (1.61[1.19-2.18]), macrosomia (1.60[1.21-2.13]) and 5-minute Apgar score ≤7 (4.09[1.04-16.08]) in the tubal disease group; placenta previa (9.33[4.22-20.62]), small for gestational age (2.29[1.04-5.08]), macrosomia (2.00[1.02-3.95]) and NICU admission (2.35[1.35-4.09]) in the endometriosis group; placenta previa (4.14[2.23-7.68]) and placenta accreta (2.05[1.08-3.87]) in the male infertility group; and GDM (1.85[1.15-2.98]), placenta previa (4.73[1.83-12.21]), placental abruption (3.39[1.20-9.56]), chorioamnionitis (2.93[1.04-8.26]), preterm birth (2.69[1.41-5.15]), and 1-minute Apgar score ≤7 (4.68[1.62-13.51]) in the mixed infertility group. Among multiple pregnancies, most of the differences that were significant in singleton pregnancies were less extensive or had disappeared.Conclusions: Infertility etiology within the IVF population was found to affect maternal and neonatal outcomes among all births. During the perinatal period, infertility etiology appears to be an additional risk factor for abnormal pregnancy outcomes besides the use of IVF techniques compared with spontaneous pregnancies. Higher risk was found for ovulation disorders, and lower risk was found for male infertility.

scholarly journals Maternal characteristics and pregnancy outcomes of Chinese women with infertility undergoing in vitro fertilization with embryonic cryopreservation: a retrospective cohort study

2020 ◽  
Author(s):  
jingxue wang ◽  
qiwei liu ◽  
Boer Deng ◽  
fang chen ◽  
xiaowei liu ◽  
...  
Keyword(s):  
Male Infertility ◽  
Pregnancy Outcomes ◽  
Chinese Women ◽  
Placenta Previa ◽  
Vitro Fertilization ◽  
Maternal Characteristics ◽  
Tubal Disease ◽  
Nicu Admission ◽  
Singleton Pregnancies

Abstract Background: To examine differences in the maternal characteristics and pregnancy outcomes of Chinese women with various causes of infertility who underwent in vitro fertilization(IVF) with embryonic cryopreservation treatment.Methods: This retrospective cohort study included women with various causes of infertility who used IVF. In order to reduce the research error, we deliberately removed the fresh ET cycles and ICSI cycles at the beginning, so in our data the IVF-ET method was frozen-embryo transfer.[MOU1] [MOU2] Data on demographic characteristics, medical history, laboratory tests, and delivery were reviewed. Logistic regression analysis was performed to calculate odds ratios and 95% confidence intervals for pregnancy and perinatal complications and neonatal outcomes. The multivariable model was adjusted for age, gravidity, parity, pre-pregnancy obesity, birth plurality, and history of previous caesarean section.[MOU3] Results: The IVF treatment group was divided into 5 subgroups according to infertility cause as follows: ovulation disorder, tubal disease, male infertility, endometriosis, and mixed infertility. Among singleton pregnancies, we verified that IVF with embryonic cryopreservation pregnancies are related to increased risks of adverse perinatal outcomes. Besides，compared with spontaneous pregnancies, IVF pregnancies were associated with significant increases in the rates of the following: gestational diabetes mellitus (GDM), preeclampsia, preterm preeclampsia, postpartum haemorrhage, intrahepatic cholestasis of pregnancy, preterm premature rupture of membranes, preterm birth, low birthweight, macrosomia, and neonatal intensive care unit (NICU) admission in the ovulation disorder group; GDM, placenta previa, placenta accreta, postpartum haemorrhage, macrosomia and 5-minute Apgar score ≤7 in the tubal disease group; placenta previa, small for gestational age, macrosomia and NICU admission in the endometriosis group; placenta previa and placenta accreta in the male infertility group; and GDM, placenta previa, placental abruption, chorioamnionitis, preterm birth, and 1-minute Apgar score≤7 in the mixed infertility group. Among multiple pregnancies, most of the differences that were significant in singleton pregnancies were less extensive or had disappeared.[MOU4] [MOU5] Conclusions: During the perinatal period, maternal characteristics, in particular type of infertility, appears an additional risk factor for abnormal pregnancy outcomes besides use of IVF techniques. Lower risk is found in male infertility and higher risk for ovulation disorders.[MOU6]

scholarly journals Pregnancy outcomes of Chinese women undergoing IVF with embryonic cryopreservation as compared to natural conception

2020 ◽  
Author(s):  
jingxue wang ◽  
qiwei liu ◽  
Boer Deng ◽  
fang chen ◽  
xiaowei liu ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Male Infertility ◽  
Pregnancy Outcomes ◽  
Placenta Accreta ◽  
Chinese Women ◽  
Placenta Previa ◽  
Tubal Disease ◽  
Nicu Admission ◽  
Minute Apgar Score ◽  
Singleton Pregnancies

Abstract Background: To examine differences in the maternal characteristics and pregnancy outcomes of Chinese women with various causes of infertility who underwent in vitro fertilization (IVF) with embryonic cryopreservation treatment.Methods: Cases were pregnancies after IVF-ET with embryonic cryopreservation; controls were spontaneously conceived pregnancies. Subgroup analysis was carried out according to etiology of infertility. The IVF treatment group was divided into 5 subgroups according to infertility etiology as follows: ovulation disorder, tubal disease, male infertility, endometriosis, and mixed infertility. Data on demographic characteristics, medical history, laboratory tests, and delivery were reviewed. Logistic regression analysis was performed for pregnancy and perinatal complications and neonatal outcomes. The multivariable model was adjusted for potential confounders.Results: Among singleton pregnancies, compared with spontaneous pregnancies, IVF pregnancies were associated with significant increases in the rates of the following: gestational diabetes mellitus (GDM) (aOR 1.76[95% CI 1.33-2.33]), preeclampsia (2.60[1.61-4.20]), preterm preeclampsia (4.52[2.03-10.06]), postpartum hemorrhage (1.57[1.04-2.36]), intrahepatic cholestasis of pregnancy (3.84[1.06-13.94]), preterm premature rupture of membranes (2.11[1.17-3.81]), preterm birth (1.95[CI 1.26-3.01]), low birthweight (1.90[1.13-3.20]), macrosomia (1.53[1.03-2.27]), and neonatal intensive care unit (NICU) admission (1.69[1.22-2.34]) in the ovulation disorder group; GDM (1.50[1.21-1.86]), placenta previa (2.70[1.59-4.59]), placenta accreta (1.78[1.10-2.89]), postpartum hemorrhage (1.61[1.19-2.18]), macrosomia (1.60[1.21-2.13]) and 5-minute Apgar score ≤7 (4.09[1.04-16.08]) in the tubal disease group; placenta previa (9.33[4.22-20.62]), small for gestational age (2.29[1.04-5.08]), macrosomia (2.00[1.02-3.95]) and NICU admission (2.35[1.35-4.09]) in the endometriosis group; placenta previa (4.14[2.23-7.68]) and placenta accreta (2.05[1.08-3.87]) in the male infertility group; and GDM (1.85[1.15-2.98]), placenta previa (4.73[1.83-12.21]), placental abruption (3.39[1.20-9.56]), chorioamnionitis (2.93[1.04-8.26]), preterm birth (2.69[1.41-5.15]), and 1-minute Apgar score ≤7 (4.68[1.62-13.51]) in the mixed infertility group. Among multiple pregnancies, most of the differences that were significant in singleton pregnancies were less extensive or had disappeared.Conclusions: Infertility etiology within the IVF population was found to affect maternal and neonatal outcomes among all births. During the perinatal period, infertility etiology appears to be an additional risk factor for abnormal pregnancy outcomes besides the use of IVF techniques compared with spontaneous pregnancies. Higher risk was found for ovulation disorders, and lower risk was found for male infertility.

scholarly journals Pregnancy outcomes of Chinese women undergoing IVF with embryonic cryopreservation as compared to natural conception

2020 ◽  
Author(s):  
Jingxue Wang ◽  
Qiwei Liu ◽  
Boer Deng ◽  
Fang Chen ◽  
Xiaowei Liu ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Male Infertility ◽  
Pregnancy Outcomes ◽  
Placenta Accreta ◽  
Chinese Women ◽  
Placenta Previa ◽  
Tubal Disease ◽  
Nicu Admission ◽  
Minute Apgar Score ◽  
Singleton Pregnancies

Abstract Background: To examine differences in the maternal characteristics and pregnancy outcomes of Chinese women with various causes of infertility who underwent in vitro fertilization (IVF) with embryonic cryopreservation treatment.Methods: Cases were pregnancies after IVF-ET with embryonic cryopreservation; controls were spontaneously conceived pregnancies. Subgroup analysis was carried out according to etiology of infertility. The IVF treatment group was divided into 5 subgroups according to infertility etiology as follows: ovulation disorder, tubal disease, male infertility, endometriosis, and mixed infertility. Data on demographic characteristics, medical history, laboratory tests, and delivery were reviewed. Logistic regression analysis was performed for pregnancy and perinatal complications and neonatal outcomes. The multivariable model was adjusted for potential confounders.Results: Among singleton pregnancies, compared with spontaneous pregnancies, IVF pregnancies were associated with significant increases in the rates of the following: gestational diabetes mellitus (GDM) (aOR 1.76[95% CI 1.33-2.33]), preeclampsia (2.60[1.61-4.20]), preterm preeclampsia (4.52[2.03-10.06]), postpartum hemorrhage (1.57[1.04-2.36]), intrahepatic cholestasis of pregnancy (3.84[1.06-13.94]), preterm premature rupture of membranes (2.11[1.17-3.81]), preterm birth (1.95[CI 1.26-3.01]), low birthweight (1.90[1.13-3.20]), macrosomia (1.53[1.03-2.27]), and neonatal intensive care unit (NICU) admission (1.69[1.22-2.34]) in the ovulation disorder group; GDM (1.50[1.21-1.86]), placenta previa (2.70[1.59-4.59]), placenta accreta (1.78[1.10-2.89]), postpartum hemorrhage (1.61[1.19-2.18]), macrosomia (1.60[1.21-2.13]) and 5-minute Apgar score ≤7 (4.09[1.04-16.08]) in the tubal disease group; placenta previa (9.33[4.22-20.62]), small for gestational age (2.29[1.04-5.08]), macrosomia (2.00[1.02-3.95]) and NICU admission (2.35[1.35-4.09]) in the endometriosis group; placenta previa (4.14[2.23-7.68]) and placenta accreta (2.05[1.08-3.87]) in the male infertility group; and GDM (1.85[1.15-2.98]), placenta previa (4.73[1.83-12.21]), placental abruption (3.39[1.20-9.56]), chorioamnionitis (2.93[1.04-8.26]), preterm birth (2.69[1.41-5.15]), and 1-minute Apgar score ≤7 (4.68[1.62-13.51]) in the mixed infertility group. Among multiple pregnancies, most of the differences that were significant in singleton pregnancies were less extensive or had disappeared.Conclusions: Infertility etiology within the IVF population was found to affect maternal and neonatal outcomes among all births. During the perinatal period, infertility etiology appears to be an additional risk factor for abnormal pregnancy outcomes besides the use of IVF techniques compared with spontaneous pregnancies. Higher risk was found for ovulation disorders, and lower risk was found for male infertility.

scholarly journals Pregnancy outcomes of Chinese women undergoing IVF with embryonic cryopreservation as compared to natural conception

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jingxue Wang ◽  
Qiwei Liu ◽  
Boer Deng ◽  
Fang Chen ◽  
Xiaowei Liu ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Male Infertility ◽  
Pregnancy Outcomes ◽  
Apgar Score ◽  
Placenta Accreta ◽  
Chinese Women ◽  
Placenta Previa ◽  
Tubal Disease ◽  
Nicu Admission ◽  
Singleton Pregnancies

Abstract Background To examine differences in the maternal characteristics and pregnancy outcomes of Chinese women with various causes of infertility who underwent in vitro fertilization (IVF) with embryonic cryopreservation treatment. Methods Cases were pregnancies after IVF-ET with embryonic cryopreservation; controls were spontaneously conceived pregnancies. Subgroup analysis was carried out according to etiology of infertility. The IVF treatment group was divided into 5 subgroups according to infertility etiology as follows: ovulation disorder, tubal disease, male infertility, endometriosis, and mixed infertility. Data on demographic characteristics, medical history, laboratory tests, and delivery were reviewed. Logistic regression analysis was performed for pregnancy and perinatal complications and neonatal outcomes. The multivariable model was adjusted for potential confounders. Results Among singleton pregnancies, compared with spontaneous pregnancies, IVF pregnancies were associated with significant increases in the rates of the following: gestational diabetes mellitus (GDM) (aOR 1.76[95% CI 1.33–2.33]), preeclampsia (2.60[1.61–4.20]), preterm preeclampsia (4.52[2.03–10.06]), postpartum hemorrhage (1.57[1.04–2.36]), intrahepatic cholestasis of pregnancy (3.84[1.06–13.94]), preterm premature rupture of membranes (2.11[1.17–3.81]), preterm birth (1.95[CI 1.26–3.01]), low birthweight (1.90[1.13–3.20]), macrosomia (1.53[1.03–2.27]), and neonatal intensive care unit (NICU) admission (1.69[1.22–2.34]) in the ovulation disorder group; GDM (1.50[1.21–1.86]), placenta previa (2.70[1.59–4.59]), placenta accreta (1.78[1.10–2.89]), postpartum hemorrhage (1.61[1.19–2.18]), macrosomia (1.60[1.21–2.13]) and 5-min Apgar score ≤ 7 (4.09[1.04–16.08]) in the tubal disease group; placenta previa (9.33[4.22–20.62]), small for gestational age (2.29[1.04–5.08]), macrosomia (2.00[1.02–3.95]) and NICU admission (2.35[1.35–4.09]) in the endometriosis group; placenta previa (4.14[2.23–7.68]) and placenta accreta (2.05[1.08–3.87]) in the male infertility group; and GDM (1.85[1.15–2.98]), placenta previa (4.73[1.83–12.21]), placental abruption (3.39[1.20–9.56]), chorioamnionitis (2.93[1.04–8.26]), preterm birth (2.69[1.41–5.15]), and 1-min Apgar score ≤ 7 (4.68[1.62–13.51]) in the mixed infertility group. Among multiple pregnancies, most of the differences that were significant in singleton pregnancies were less extensive or had disappeared. Conclusions Infertility etiology within the IVF population was found to affect maternal and neonatal outcomes among all births. During the perinatal period, infertility etiology appears to be an additional risk factor for abnormal pregnancy outcomes besides the use of IVF techniques compared with spontaneous pregnancies. Higher risk was found for ovulation disorders, and lower risk was found for male infertility.

scholarly journals Maternal characteristics and pregnancy outcomes among Chinese women with infertility undergoing assisted reproductive technology: a retrospective cohort study

2019 ◽  
Author(s):  
jingxue wang ◽  
qiwei liu ◽  
Boer Deng ◽  
fang chen ◽  
xiaowei liu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Chinese Women ◽  
Placenta Previa ◽  
Reproductive Technology ◽  
Male Factor ◽  
Maternal Characteristics ◽  
Tubal Disease

Abstract Background: To examine differences in maternal characteristics and pregnancy outcomes among Chinese women with infertility due to various reasons who underwent assisted reproductive technology(ART). Methods: This retrospective cohort study included women who used ART for various reasons. Demographics, medical history, laboratory tests, and delivery data were reviewed. Results: The ART treatment group was divided into 5 subgroups according to reason for infertility: ovulation disorder, tubal disease, male factor, endometriosis, multiple infertility-related diagnoses. Compared with spontaneous pregnancies, significant increases in the following were observed with ART: rates of gestational diabetes mellitus(GDM), preeclampsia, preterm premature rupture of membranes, postpartum hemorrhage, and chorioamnionitis in ovulation disorder; GDM, placenta previa and postpartum hemorrhage in tubal disease; placenta previa in endometriosis and male factor; and GDM, placenta previa and chorioamnionitis in multiple infertility-related diagnoses. Preterm birth, low birthweight, and small for gestational age were increased in all ART groups. Macrosomia and neonatal intensive care unit admission were increased in maternal factors with ART. Conclusions: During the perinatal period, women with different reasons for undergoing ART have different maternal characteristics and infant outcomes when compared with women not using ART, perinatal morbidities are higher in women undergoing ART for most reasons. The worst and best prognoses for infertility were found for that caused by ovulation disorder and male factor, respectively.

scholarly journals Maternal and neonatal outcomes of repeated antepartum bleeding in 493 placenta previa cases: a retrospective study

2020 ◽  
Author(s):  
Jiang ziyan ◽  
shiyun huang ◽  
qing zuo ◽  
zhiping ge ◽  
hongmei lu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Elective Surgery ◽  
Placenta Previa ◽  
Late Pregnancy ◽  
Neonatal Outcomes ◽  
Maternal Characteristics ◽  
Increased Risk ◽  
History Of ◽  
Nicu Admission

Abstract Background Placenta previa (PP) is a serious complication of late pregnancy. Exploring the effect of antepartum bleeding caused by PP on pregnancy outcomes is very important.Methods We retrospectively analyzed 493 women complicated with PP. Patients were divided into antepartum repeated bleeding and non-bleeding groups. Maternal characteristics and pregnancy outcomes were compared.Results The risk of antepartum hemorrhage was 2.038 times higher when gravidity was 5 (95% CI 1.104 ~ 3.760, P = 0.023). Pregnant women with a history of more than three intrauterine procedures had a 1.968 times higher risk of antepartum hemorrhage (95% CI 1.135 ~ 3,412, P = 0.016) compared to pregnant women without any intrauterine procedures. The risk of antepartum bleeding was found to be decreasing with the pregnancy advancing; When the placenta edge was noted to be over cervival os, the risk of antepartum bleeding was 4.385-fold than the low-lying plcaenta cases (95%CI2.454ཞ8.372,P = 0.000). In the respect of maternal outcomes, the repeated bleeding group, the risk of emergency surgery was 7.213 times higher than elective surgery (95% CI 4.402ཞ11.817, P = 0.000). As for the neonatal outcomes, the risk of asphyxia was 2.970 times and the risk of NICU admission was 2.542-fold higher in repeated bleeding group compared to non-bleeding group, respectively.Conclusions Obstetricians should be aware of the increased risk of antepartum bleeding especially for ≤ 34 weeks and placenta edge over cervical os PP patients, they have a higher risk of antepartum bleeding. These women have higher possibility of emergency c-section and need preterm newborn resuscitation.

scholarly journals Pregnancy outcomes in patients with placenta previa on a cesarean scar

2019 ◽  
Author(s):  
Zhiheng Guo ◽  
Yanhong Shan ◽  
Huiying Xu ◽  
Yi Yang
Keyword(s):  
Birth Weight ◽  
Pregnancy Outcomes ◽  
Apgar Score ◽  
Placenta Previa ◽  
Post Partum ◽  
Placenta Praevia ◽  
Low Birth Weight Infant ◽  
Post Partum Hemorrhage ◽  
Cesarean Scar ◽  
Minute Apgar Score

Abstract OBJECTIVE: We aimed to examine the clinical features and pregnancy outcomes in patients with placenta previa on a cesarean scar. METHODS: A retrospective review of women who were diagnosed with placenta previa on a cesarean scar in the First Bethune Hospital of Jilin University between December 2011 and December 2017 was performed. Basic patient characteristics and pregnancy outcomes data were collected. Characteristics that are associated with maternal morbidities (post-partum hemorrhage ≥ 2000 ml and nits transfused >4) and adverse neonatal outcomes (5-minute Apgar <7 and Low-birth-weight infant) were evaluated. RESULT ： A total of 183 patients was identified. PAS disorders were observed in 63 cases(34.4%).The median postpartum hemorrhage was 700 ml (range,100-7900).70 patients (38.2%) had a blood loss ≥ 2000 mL.43 subjects(23.4%) required >4 units of blood. The median 1-minute Apgar score and 5-minute Apgar score was 9 and 9.2 respectively. Additionally ， median neonatal birth weight was 1880g (range, 700-4260). Patients with comorbid PAS disorders are more likely subject to post-partum hemorrhage and require units transfused (>4) (p <0.05). Similarly, patients with major placenta praevia had a higher incidence of post-partum hemorrhage and units transfused (>4) than patients with minor placenta praevia (p <0.05). Patients who undertook emergency cesarean due to hemorrhage were more likely to have a low-birth-weight infant than women who undertook planned cesarean. CONCLUSION: PPP is associated with considerable maternal and fetal morbidity, particularly in patients with comorbid PAS disorders. Delayed delivery may be warranted for those without meaningful vaginal bleeding and preterm labor but need further prospective clinical trials to confirm.

Comparison of pregnancy outcomes after second trimester amniocentesis between procedures performed by experts and non-experts

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tanapak Wisetmongkolchai ◽  
Fuanglada Tongprasert ◽  
Kasemsri Srisupundit ◽  
Suchaya Luewan ◽  
Kuntharee Traisrisilp ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Loss Rate ◽  
Fetal Loss ◽  
Adverse Pregnancy Outcomes ◽  
Expert Group ◽  
Second Trimester ◽  
Single Institution ◽  
Adverse Pregnancy ◽  
In Pregnancy ◽  
Singleton Pregnancies

AbstractObjectivesTo compare the rate of fetal loss in pregnancy after second trimester amniocentesis between procedures performed by experts and non-experts and to assess other pregnancy complications as secondary outcomes.MethodsA retrospective cohort study was performed on singleton pregnancies that underwent mid-trimester amniocenteses in a single institution. The fetal loss rates of procedures performed by experts and non-experts were collected and analyzed. Other adverse pregnancy outcomes were also examined.ResultsIn total, 14,450 amniocenteses were performed during the study period. These included 11,357 (78.6%) procedures in the group expert operators and 3,093 (21.4%) procedures in the group non-expert operators. In the non-expert group, the fetal loss rate was slightly increased but not significantly (p=0.24).In addition, the higher number of spontaneous abortions was associated with blood-stained amniotic fluid sample (p<0.001; RR=9.28). Multiple needle insertions also increased in the non-expert group significantly. However, no difference in pregnancy outcomes was found between in single and multiple needle insertions.ConclusionsThe amniocentesis procedures performed by the non-experts was not increase the fetal loss rate. However, the other adverse pregnancy outcomes, including preterm birth, low birth weight and fetal growth restriction were significantly increased in the non-expert group.

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