Maternal Morbidity, Neonatal SEPSIS, Perinatal Mortality
Conditions
Keywords
Twins, ART, Induction of Ovulation, Perinatal mortality
Brief summary
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
Detailed description
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 .
Interventions
None listed
Sponsors
Hawler Medical University
Study design
Observational model
CASE_ONLY
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
No
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Admission to neonatal care unit in days | up to 7 days | Fetal care unit |
| Maternal diabetes using glucose tolerance test | up to 7 days postpartum | 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 |
| 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 | up to 1 week postpartum | 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) |
| Maternal anemia using WHO criteria | up to 1 week | Hemoglobin level less than 11gm/dl |
| Postpartum hemorrhage | up to 1 week | Bleeding from genital tract of 500 mL or more vaginally |
| Neonatal weight in kilogram | up to 7 days | 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 |
| Neonatal Apgar(Appearance, Pulse, Grimace, Activity, and Respiration) score | first and fifth minute of life | 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\> |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Maternal mode of delivery | during labor | Cesarean section or vaginal delivery |
Countries
Iraq
Outcome results
None listed