Complication rates in the second and third trimester of spontaneous twin pregnancies and twin pregnancies after in vitro fertilization.

BACKGROUND: Most authors agree that the twin pregnancies have a higher risk of complications compared to singleton pregnancies. However, there is no unanimity as to whether the risk of complications in twin pregnancies resulting from in vitro fertilization is higher than in twin pregnancies resulting from spontaneous conception.

OBJECTIVE: The aim of this study was to estimate the frequency rates of complications in the second and third trimester of dichorionic-diamniotic twin pregnancies resulting from IVF (group I) compared to dichorionic-diamniotic and monochorionic-diamniotic twin pregnancies resulting from spontaneous conception (group II and III).

RESULTS: The rate of cesarean section and cervical cerclage was significantly higher in the group I. Polyhydramnios occurred less frequently in group I than in group III. The discordant growth of fetuses occurred significantly more frequently in the group I. The frequency of other complications did not differ in the studied groups. The Apgar score was similar in the group I and II but significantly lower in the group III compared to the group I.

CONCLUSIONS: 1) The frequency of complications in twin pregnancies after IVF is similar to those in the twin pregnancies conceived spontaneously. 2) In the twin pregnancies after IVF it is necessary to expect only a higher frequency of caesarean sections, cervical incompetence and a discordant growth of the twins when comparing with twin pregnancies conceived spontaneously. 3) In the twin pregnancies after IVF the intrauterine fetal demise and polyhydramnios occurred less frequently than in monochorionic-diamniotic pregnancies after spontaneous conception.