Antepartum, Intrapartum and Perinatal Outcome of Twin Pregnancies After In Vitro Fertilization

Objective: The aim of this study was to evaluate antepartum, intrapartum and perinatal complications in spontaneous versus in vitro fertilization twins. Materials and Methods: We conducted a retrospective cohort study of twin pregnancies delivered at the Suleyman Demirel University, Faculty of Medicine, Department of Obstetrics and Gynecology and Isparta Women's and Children's Hospital between 1999 and 2005. Controls were identified from spontaneous multiple pregnancies delivered in the same time period. A total of 52 cases and 104 controls were studied. They were compared with respect to various maternal and neonatal complications. Results: Mean maternal age, the proportion of nulliparaous women, the incidence of premature rupture of membranes, cesarean section, and premature delivery were significantly higher in the study group. The cesarean delivery rate was significantly higher in cases of twins who were conceived by in vitro fertilization (84% vs 67%, p<0.05). The preterm delivery rate was also significantly higher (55% vs 47%, p< 0.05)and no significant difference was present between the groups with respect to the gestational age (34 +/- 4 weeks vs 35 +/- 3 weeks). The number of perinatal deaths, stillbirths, fetal distress, cord prolapse, and neonatal intensive care unit admissions was similar in both groups. Discusssion: When compared with control twins, in vitro fertilization twins are more likely to be delivered by cesarean delivery and to have a higher incidence of preterm birth. This study provides further evidence for a different outcome of in vitro fertilization twin pregnancies in comparison with spontaneously conceived twin pregnancies.