The Impact of Assisted Reproductive Technology in Twin Pregnancies Complicated by Intrahepatic Cholestasis of Pregnancy: a Retrospective Cohort Study

Abstract

Introduction Our study aims to evaluate the perinatal outcomes in twin pregnancies diagnosed with intrahepatic cholestasis of pregnancy (ICP) and to compare these with normal healthy twin pregnancies for perinatal outcomes. The second outcome of the study was to determine whether in vitro fertilization-embryo transfer (IVF-ET) affects the perinatal outcome in ICP patients. Materials and Methods In this study, 59 ICP and 641 healthy twin pregnancies were compared for perinatal outcomes retrospectively. According to the mode of conception, the twin pregnancies with ICP were divided into 2 groups. The twin pregnancies with ICP who were conceived with IVF were referred to as the IVF-ET group. The twin pregnancies with ICP who were conceived spontaneously or by ovulation induction and intrauterine insemination (IUI) were referred to as the non-IVF-ET group. Results Twin pregnancies with ICP give birth significantly earlier than normal twin pregnancies (p ˂ 0.001). The diagnosis of ICP occurred significantly earlier in the IVF-ET pregnancy with ICP than in the non-IVF-ET group. In twin pregnancies with IVF-ET, patients delivered significantly earlier than in the non-IVF-ET group (p=0.002). Twin pregnancies with ICP were found to have significantly higher rates of meconium-stained amniotic fluid, postnatal intubation, and admission to the neonatal intensive care unit (NICU) than healthy twin pregnancies. Conclusions ICP is a risk factor for preterm delivery in twin pregnancies. In addition, ICP develops earlier and more frequently in twin pregnancies from IVF-ET than in those from non-IVF twin pregnancies, and the disease may be more serious.

Effect of intrahepatic cholestasis of pregnancy on infantile food allergy: A retrospective longitudinal study cohort in Southwest China

“…Consistent with previous studies [11,35,36], we found that maternal serum total bile acid levels worsened among twin pregnancies. Pregnant women with twin pregnancy have higher fasting serum total bile acid levels and are more likely to suffer from severe intrahepatic cholestasis of pregnancy.…”

“…It is most common in South America and northern Europe [8][9][10]. There is a higher incidence of intrahepatic cholestasis of pregnancy in women with a multiple pregnancy (up to 22% in one study) [11,12].…”

Внутрішньопечінковий Холестаз Вагітних Після Застосування Допоміжних Репродуктивних Технологій: Клінічні Особливості

“…Вагітних після допоміжних репродуктивних технологій (ДРТ) відносять до групи ризику акушерських і перинатальних ускладнень, зокрема і ВПХВ, що обумовлено як негативним впливом самих технологій, старшим віком жінок, так і супутніми соматичними станами, серед яких певне місце посідає ендокринна та гепатобіліарна патологія [4,5,6].…”

ROC Curve Analysis of the Sensitivity and Specificity of Biochemical Detection of Intrahepatic Cholestasis during Pregnancy

“…Through the discussion of intrahepatic cholestasis of pregnancy and biochemical detection sensitivity and specifi city, we set up a more reliable diagnosis of ICP based on lower transaminase activity cut-off values for the early diagnosis and intervention of clinical ICP; provided a certain theoretical basis for future research; created ICP patient nursing assessments that are more scientifi c, accurate, and eff ective; and guided nurses to take timely preventive measures, which is of vital signifi cance [ 26 ] . Our retrospective analysis also has some limitations.…”