PERINATOLOGIYA I PEDIATRIYA. 2016.3(67):66-71; doi 10.15574/PP.2016.67.66 
 

Comparative analysis of pregnancy course, childbirth and newborns condition at natural twins and IVF twins 
 

Skrypchenko N. Y., Shamayeva O. V., Hrebinichenko A. O., Podolsky Vol. V., Mazur T. M., Pavlova O. M.

SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine», Kyiv

Purpose — to compare the features of pregnancy course, childbirth and newborns condition in twins of natural origin and IVF twins considering the horial and amniotic types.

Patients and methods. The study included 51 pregnant women with twins: 55.0% (n=28) twins have a natural origin, 45.0% (n=23) — came after ART. 64.0% of spontaneous twins were monohorial (including: monohorial biamniotic — 53.0%, monohorial monoamniotic — 11.0%) and 36.0% — bihorial (all — biamniotic). All IVF twins were bihorial biamniotic.

Results. All pregnantwomen with twins, either natural or after IVF, are all at high risk of maternal and perinatal complications, such as: risk of miscarriage and premature birth, CIN, placental dysfunction and fetal distress, premature rupture of the amniotic membranes and high perinatal mortality. Complications of pregnancy thus have clear differences, depending on the origin of twins, for women with twins after IVF was characterized by a high risk of miscarriage (over 90.0%), preterm birth (70.0%) and preeclampsia (26.0% ), which were, respectively, 1.7; and almost 2 and 7 times higher than in women with natural twins (p<0.05). Against this background, the condition of natural newborn twins was better than the IVF twins condition (1.5 times), which is associated with the birth in women with spontaneous twins more full-term infants. The main feature of complications of natural twins pregnancy is a direct link with choriality: the most severe perinatal complications such as fetal death, were peculiar to diamniotic monochorionic twins, and accounted more than 20.0% of cases, this is almost 5 times higher than in women with IVF twins (p<0.05). The frequency of the feto-fetal transfusion syndrome in this case was 14.0%.

Conclusions. The preventive ways of perinatal complications in twins are: early ultrasound diagnostics and monitoring, prevention of placental insufficiency starting from early pregnancy terms, prolongation of pregnancy till the delivery term.

Key words: twins, natural twins, IVF twins, chorionity, amnionity.

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