Pathology of the fetus and placenta after IVF: A retrospective study
DOI:
https://doi.org/10.37800/RM.2.2023.53-59Keywords:
IVF, placenta, placenta previa, congenital malformations, retrochorial hematoma, premature detachment of the normally located placenta, fetal chromosomal abnormalitiesAbstract
Relevance: To date, it has been convincingly shown that pregnancy after in vitro fertilization (IVF) belongs to the high-risk group. In pregnancy after IVF and the embryo transfer, the frequency of fetoplacental insufficiency is observed in more than 70% of cases, fetal growth retardation occurs in 18-30% of cases, and placenta previa – in 2% of pregnancies conceived with assisted reproductive technologies (ART). The frequency of fetal malformations after ART can reach 4,4%, twice as high as in the general population (2,05%); most are associated with congenital heart defects and central nervous and musculoskeletal system malformations. Chromosomal abnormalities and epigenetic defects are significantly more common.
The study aimed to determine the frequency of fetal and placental pathology development after using IVF.
Materials and methods: Conduct a literature review over the past five years on evidence bases: PubMed, Medline, Cochrane Library, LILACS, WHO, Scopus and Web of Science, and Google Scholar to find peer-reviewed publications.
The study was conducted at PERSONA International Clinical Center for Reproductology (Almaty, Kazakhstan). A retrospective analysis included 320 cards of pregnant women registered for pregnancy from 9-10 weeks in the Persona ICCR from 2018 to 2022. The participants were divided into two groups: the IVF group included pregnant women after IVF (n=162), and the comparison group included women with spontaneous pregnancy (n=158).
Results: Fetal congenital malformations were more common after IVF (11.1% vs. 5.7%); most were associated with congenital heart defects and malformations of the urinary and musculoskeletal systems. A high risk of chromosomal pathology (6.7% vs. 3.1%), low placentation (19.7% vs. 12%), retrochorial hematoma (26% vs. 11%), and placenta abruption were significantly more common in the group after IVF.
Conclusion: Considering the obtained results, one can think about an increased risk of chorionic and placenta previa, retrochorial hematoma, premature detachment of a normally located placenta, chromosomal abnormalities, and congenital malformations in patients after IVF. The high frequency of fetus and placenta pathologies in patients after ART urges the development of clinical guidelines for managing pregnancy in the antenatal period to reduce the frequency of obstetric and perinatal complications.
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