Fetomaternal Complications of In Vitro Fertilization Pregnancies in a Tertiary Center

Abstract

A b s t r ac t Introduction: Over the past decade, the use of assisted reproductive technology (ART) has increased dramatically. In vitro fertilization (IVF) is the most frequently practiced ART procedure. There has been an increasing trend in a number of pregnancies in IVF conception since it was first introduced in 1981. Multifetal gestation and its outcomes are the greatest risks of IVF pregnancy. There is an increased risk of prelabor rupture of membranes (PROM), preterm labor, low birth weight (LBW), and small for gestational age infants. It is also associated with increased maternal complications during pregnancy, including gestational diabetes mellitus (GDM), preeclampsia, intrahepatic cholestasis of pregnancy, placental abruption, placenta praevia, adherent placenta, polyhydramnios, and postpartum hemorrhage. Thus, pregnancies after IVF conception require more vigilant monitoring. Objective: Assess maternal and fetal complications of IVF pregnancies and IVF conception. Study design: Retrospective single-arm analysis of pregnancies with IVF complications over a period of 3 years from September 2014 to August 2017. Results: A total of 104 women underwent IVF conception, with the highest incidence in women of age more than 30 years (56.73% of the cases). There were eight cases of abortion. Among the total cases who underwent IVF conception, 73 (70%) women were primigravidae, and 31 (30%) were multigravidae. The risk of maternal complications was 87.5%. Multifetal gestation was the most common maternal complication (39.4%), with an incidence of twin pregnancy of 37.5%, out of which 32.7% were dichorionic diamniotic (DCDA) twins and 4.8% were monochorionic diamniotic (MCDA) twins, followed by preterm labor (17.3%). The total number of viable newborns delivered was 140, with 43.2% being LBW (<2.5 kg). A total of 45 babies (32.1%) required neonatal intensive care unit (NICU) admissions, out of which three babies (2.1%) succumbed. Conclusion: There is a need for more vigilant monitoring of IVF pregnancies in view of a higher rate of maternal and fetal complications.