Autologous and heterologous assisted reproductive technology (ART) conceptions have been on the rise for the last few decades and alongside with that have the rate of multiple pregnancies. Multiple gestations are associated with high odds of gestational complications and, in turn, adverse delivery and feto-neonatal outcomes. Whether ART-conception further increases such elevated risk is still debated. ART is more commonly accessed by older women with chronic diseases, which relate to heightened likelihood of complications. We decided to investigate the influence of autologous and heterologous ART conception compared to spontaneous conception on delivery and feto-neonatal outcomes of diamniotic twin pregnancies in a cohort of healthy women with no chronic conditions or gestational complications. Retrospective cohort study among diamniotic twin pregnancies in mothers without pregestational or gestational disease. Delivery and feto-neonatal outcomes were compared among three groups according to mode of conception: (1) spontaneous conception (SC, referent group, = 251 pregnancies), (2) autologous ART-conception (A-ART, = 87), and (3) heterologous ART-conception (H-ART, = 22). At adjusted analyses, twin pregnancies conceived by A-ART showed a twofold heightened risk of delivery by urgent/emergent cesarean section, as well as four and sevenfold increase in odds of blood loss >1000 and >1500 mL, respectively. H-ART pregnancies were at fivefold higher risk of undergoing prelabor cesarean section compared to SC, whereas no differences were identified for odds of severe post-partum hemorrhage. Also, A-ART and H-ART gestations displayed fetal and neonatal outcomes similar to SC pregnancies when analysis was adjusted for relevant confounding factors. Our results suggest that both A-ART and H-ART conception associate with increased odds of operative delivery among diamniotic twin pregnancies in healthy mothers with no chronic diseases or gestational complications. Also, a higher risk of severe postpartum hemorrhage appears to relate to A-ART independent of mode of delivery and maternal age. Further studies with larger series of uncomplicated twin pregnancies are warranted to improve our understanding of the relationship of ART to adverse delivery outcomes.
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http://dx.doi.org/10.1080/14767058.2018.1540036 | DOI Listing |
Prenat Diagn
January 2025
Department of Preventive Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Introduction: Fetoscopic laser surgery (FLS) is the gold standard treatment for monochorionic (MC) twin pregnancies complicated by twin-twin transfusion syndrome (TTTS). The aim of our study was to evaluate the rate and risk factors for cord entanglement in the presence of iatrogenic monoamnioticity (iMA), a consequence of inadvertent septostomy during FLS.
Methods: This is a retrospective analysis of two consecutive cohorts of FLS performed either using the selective technique from January 2004 to January 2012, or with the Solomon technique, from that date onwards.
J Nutr Biochem
January 2025
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University.; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan 610041, China.. Electronic address:
Zinc is an essential trace element. The regulatory mechanism of zinc and its transporters in fetal growth in monochorionic diamniotic (MCDA) twins with selective intrauterine growth restriction (MCDA-sIUGR) is unclear. A total of 45 MCDA twins were divided into two groups, MCDA (n=37) and MCDA-sIUGR (n=8), to investigate their possible effects on fetal growth.
View Article and Find Full Text PDFMidwifery
January 2025
School of Health, Education, Policing and Sciences, University of Staffordshire, UK.
Problem: Tongue tie is an added complication when breastfeeding, but little is known about the role tongue tie might play when breastfeeding twins.
Background: Twins are much less likely to be breastfed than singleton babies due to added complications regarding pregnancy, birth and ongoing care. Tongue tie can cause breastfeeding barriers including poor latch, inefficient milk transfer and nipple pain.
Anim Reprod Sci
January 2025
Agrotecnio Center, Department of Animal Sciences, University of Lleida, Lleida 25198, Spain.
The objectives of this study were: (i) to evaluate the associations between postpartum health disorders, relative increase in walking activity (RIWA) and expression of behavioral estrus intensity captured by pedometers; (ii) to assess associations between RIWA and pregnancy in cows submitted to timed artificial insemination (TAI). Lactating dairy cows (n = 881) were enrolled in the study. Cows were submitted to a 5d TAI protocol with insertion of a progesterone device.
View Article and Find Full Text PDFHum Reprod
January 2025
Next Fertility GynePro, Bologna, Italy.
In recent years, the transfer of more than one embryo has become less frequent to diminish multiple pregnancies. Even so, there is still a risk of one embryo splitting into two or even three. This report presents the case of a triamniotic monochorionic gestation in a 35-year-old woman, obtained after the transfer of a single day 5 embryo that had been previously hatched with a laser and subsequently transferred in a fresh IVF cycle.
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