体外受精双绒毛膜双羊膜双胞胎新鲜胚胎与冻融移植后的胎盘病理

IF 3 2区医学 Q2 DEVELOPMENTAL BIOLOGY

Placenta Pub Date : 2024-11-26 DOI:10.1016/j.placenta.2024.11.015

Ekaterina Shlush , Talal Sarhan , Rudi Hammudi , Ala Aiob , Alejandro Livoff , Susana Mustafa Mikhail , Lior Lowenstein , Inshirah Sgayer

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引用次数: 0

摘要

前言：比较新鲜胚胎移植（ET）和冷冻解冻胚胎移植（ET）后体外受精（IVF）双绒毛膜双羊膜双胎妊娠胎盘的组织病理学结果。方法回顾性研究2010-2022年IVF双羊膜双胎妊娠的结果。胎盘研究结果根据2016年阿姆斯特丹胎盘研讨会小组共识声明的定义进行分类。构建了多变量逻辑分析来估计胎盘组织病理学异常发现的优势比（OR），调整了母亲年龄、体重指数和无产。结果新鲜ET妊娠（n = 236）的平均出生胎龄低于冻融ET妊娠（n = 122）（34.89 vs 35.77周，p = 0.003）。与冻融ET组相比，新鲜ET组早产（69.5%比55.7%,p = 0.011）和低出生体重(71.6%比57.4%,p <；0.001)和非常低的出生体重（14.2% vs 9.0%， p值单侧= 0.029）。新鲜ET组与冻融ET组相比，母体血管病变（20.3%比11.5%,p = 0.003）、胎盘出血（12.7%比7%，p = 0.021）和与母体血管病变相关的绒毛病变（7.2%比3.7%，p值单侧= 0.04）的发生率更高。多因素logistic分析显示，与冷冻解冻体外受精相比，新鲜体外受精后双胎妊娠孕妇或新生儿血管病变的风险更高（调整or = 1.91, 95% CI 1.26-2.92, p = 0.011）。结论新鲜ET与冻融ET相比，产科和新生儿结局更差，产妇血管病变的风险更大。

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Placental pathology of IVF-conceived dichorionic diamniotic twins after fresh embryo versus frozen-thawed transfer

Introduction

To compare histopathological findings of placentas of dichorionic diamniotic twin pregnancies of in-vitro fertilization (IVF), conceived after fresh embryo transfer (ET) and frozen-thawed ET.

Methods

This retrospective study compared dichorionic diamniotic twin IVF pregnancies that resulted in livebirths during 2010–2022. The placental findings were classified according to definitions curated by the 2016 Amsterdam Placental Workshop Group Consensus Statement. A multivariate logistic analysis was constructed to estimate the odds ratios (OR) of placental histopathology abnormal findings, adjusted for maternal age, body mass index and nulliparity.

Results

The mean gestational age at birth was lower following fresh ET pregnancies (n = 236) than frozen-thawed ET pregnancies (n = 122) (34.89 vs 35.77 weeks, p = 0.003). For the fresh ET compared to the frozen-thawed ET group, rates were higher of preterm birth (69.5 % vs. 55.7 %, p = 0.011), low birthweight (71.6 % vs 57.4 %, p < 0.001) and very low birthweight (14.2 % vs 9.0 %, p value one sided = 0.029). For the fresh ET compared with the frozen-thawed ET group, the rates were higher of maternal vascular lesions (20.3 % vs. 11.5 %, p = 0.003), placental hemorrhage (12.7 % vs. 7 %, p = 0.021), and villous lesions related to maternal vascular lesions (7.2 % vs. 3.7 %, p value one sided = 0.04). A multivariate logistic analysis showed a higher risk of maternal or neonatal vascular lesions for twin pregnancies after fresh ET than frozen-thawed ET (adjusted OR = 1.91, 95 % CI 1.26–2.92, p = 0.011).

Conclusions

Following fresh ET compared to frozen-thawed ET, obstetrical and neonatal outcomes were worse, and the risk of maternal vascular lesions was greater.

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来源期刊

Placenta 医学-发育生物学

CiteScore

6.30

自引率

10.50%

发文量

391

审稿时长

78 days

期刊介绍： Placenta publishes high-quality original articles and invited topical reviews on all aspects of human and animal placentation, and the interactions between the mother, the placenta and fetal development. Topics covered include evolution, development, genetics and epigenetics, stem cells, metabolism, transport, immunology, pathology, pharmacology, cell and molecular biology, and developmental programming. The Editors welcome studies on implantation and the endometrium, comparative placentation, the uterine and umbilical circulations, the relationship between fetal and placental development, clinical aspects of altered placental development or function, the placental membranes, the influence of paternal factors on placental development or function, and the assessment of biomarkers of placental disorders.