Outcomes in Spontaneous and ART Twin Pregnancies

Hawler Medical University200 enrolled

Overview

During the last decades, assisted reproductive technique has been transformed from a miracle to real and has become widely used for treatment human infertility. this was associated with increased the rate of twin pregnancies

Twin pregnancies are associated with an increased risk of maternal mortality \& morbidity and an increase in the incidence of neonatal morbidity and mortality compared to singleton pregnancy. The heterogeneous results reported so far can also depend on differences in the studied populations and/or in the management approach to twin pregnancy, variability in data regarding neonatal and maternal outcomes. Evidence on pregnancy outcomes of twins conceived by artificial reproductive technology (ART) compared with those naturally conceived (NC) is conflicting, A 2004 systematic review and a large 2008 study both were praised that in cases of twin pregnancy after assisted conception the perinatal mortality is significantly lower, when compared with those spontaneously conceived .

Study Type

OBSERVATIONAL

Enrollment

200

Conditions

Neonatal SEPSIS Perinatal Mortality Maternal Morbidity

Eligibility

Sex: FEMALE

Medical Language ↔ Plain English

Inclusion Criteria: * Twin delivered \>24-week gestational age * weight ≥ 500g * Diachronic diamniotic twins. Exclusion Criteria: * Intrauterine fetal deaths * Higher-order multiple pregnancies * Deliveries complicated by early vanishing fetuses * Twin pregnancies reduced to singleton * Triple pregnancy reduced to twin.

Locations (1)

Kurdistan Board for Medical speciality

Erbil, Kurdistan Region, Iraq

Outcomes

Primary Outcomes

Maternal diabetes using glucose tolerance test

The diagnosis of GDM was based a fasting plasma glucose level of ≥5.6 mmol/L with 2 h plasma glucose level of ≥7.8 mmol/L

Time frame: up to 7 days postpartum

Hypertension during pregnancy and preeclampsia diagnosed using ACOG guideline a) weight in kilogram b) Apgar score in first and 10th minutes c)Admission to neonatal intensive acre unit measured in days

Systolic and diastolic blood pressure equal or more than140/90 mm Hg measured on two or more occasions after 20 weeks of gestation in previously normotensive women, with or without proteinuria (proteinuria of \>100 mg/dL by urine analysis, or \>300 mg/24 h)

Time frame: up to 1 week postpartum

Maternal anemia using WHO criteria

Hemoglobin level less than 11gm/dl

Time frame: up to 1 week

Postpartum hemorrhage

Bleeding from genital tract of 500 mL or more vaginally

Time frame: up to 1 week

Neonatal weight in kilogram

categorized as extreme low birth weight (LBW) for \<1000 g, very LBW for 1000-1500 g, LBW for 1500-2500 g, and normal birth weight for \>2500 g

Time frame: up to 7 days

Neonatal Apgar(Appearance, Pulse, Grimace, Activity, and Respiration) score

Apgar scores includes 10 sores , 2 for each . The Apgar score was classified as severely depressed \<0-3\>, moderately depressed\<4-6\> and excellent condition\<7-10\>

Time frame: first and fifth minute of life

Admission to neonatal care unit in days

Fetal care unit