Abstract
Background. Infertility remains a significant issue in reproductive medicine, and pregnancy following IVF requires specialised medical supervision due to differences in its course compared with physiological pregnancy.
Aim. To determine the characteristics of pregnancy, labour, and neonatal outcomes in women whose pregnancies resulted from in vitro fertilisation.
Materials and methods. A retrospective clinical and statistical analysis was conducted of 318 pregnancy and delivery records, as well as medical records of newborns of women whose pregnancies resulted from IVF (Group I), and 137 pregnancy and delivery records of women who conceived spontaneously (Group II). All patients received treatment and delivery care in the obstetric department of the multidisciplinary medical centre “Leleka” (Kyiv) during the period from 2020 to 2024.
Results. Women in Group I were characterised by a higher incidence of moderate pre-eclampsia – 94 cases (29.6%), compared with 21 cases (15.3%) in Group II (p < 0.05), placental dysfunction – 198 cases (62.3%) versus 43 cases (31.4%) in Group II (p < 0.05), which was accompanied by foetal growth restriction – 99 cases (31.1%) compared with 19 cases (13.9%), abnormal amniotic fluid volume – 141 cases (44.3%) versus 14 cases (10.2%) in Group II (p < 0.05), and vaginitis – 177 cases (55.7%) compared with 29 cases (21.1%) in Group II (p < 0.05). The incidence of severe pre-eclampsia, 19 cases (5.9%) in Group I and 2 cases (2.1%) in Group II, showed no statistically significant difference (p > 0.05). Regarding the timing of delivery, women in Group I had a lower rate of term births – 186 cases (58.5%) compared with 107 cases (78.1%) in Group II (p < 0.05), against a background of an increased number of preterm births – 87 cases (27.4%) versus 14 cases (10.2%) (p < 0.05), and post-term births – 45 cases (14.1%) compared with 16 cases (11.7%) in Group II (p > 0.05). Within the structure of preterm births among women in Group I, 10 cases (3.1%) occurred at 22-27 weeks + 6 days. There was no significant difference in the number of preterm births at 28-33 weeks + 6 days (Group I – 26 cases (8.2%), Group II – 4 cases (2.9%), p > 0.05) or at 34-36 weeks + 6 days (Group I – 51 cases (16.0%), Group II – 10 cases (7.3%), p > 0.05). Analysis of labour demonstrated a higher incidence of abnormalities of labour activity among women in Group I – 94 cases (29.6%) compared with 19 cases (13.8%) in Group II (p < 0.05), mainly due to uterine inertia – 66 cases (20.7%) versus 7 cases (5.1%) (p < 0.05), with successful medical correction achieved in 59 cases (62.7%) in Group I and 16 cases (84.2%) in Group II (p < 0.05).
Conclusions. During 2022-2024, the number of pregnancies and births following IVF increased by 56%, and their complicated course may be associated with obstetric history, impaired placentation, and the specific characteristics of pregnancy after IVF.