Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-04T19:03:08.337Z Has data issue: false hasContentIssue false

9 - Early pregnancy complications after assisted reproductive technology

Published online by Cambridge University Press:  22 October 2009

Natalie Greenwold
Affiliation:
Department of Obstetrics and Gynaecology, University College London, London, UK
Paul Serhal
Affiliation:
The University College London Hospitals
Caroline Overton
Affiliation:
Bristol Royal Infirmary
Get access

Summary

The availability of prenatal diagnosis has expanded, in particular with great advances in ultrasound imaging enabling investigation of the fetus from three weeks after conception. Because pregnancies resulting from assisted reproductive technology (ART) undergo regular ultrasound examination, often on a weekly basis, they have been an invaluable source of information on normal and abnormal human development in utero. For example, most measurement charts used in early pregnancy units have been constructed from the investigation of ART pregnancies.

Miscarriage is the most common complication of spontaneous and artificial gestations (Table 9.1). In cases of miscarriage the diagnosis of a specific anomaly has important epidemiological value and may help to elucidate unclear mechanisms implicated in some cases of early pregnancy loss (EPL). Because of the perceived need to stimulate excess follicles and transfer more than two embryos to achieve high pregnancy rates, multiple gestation pregnancy (MGP) rates are higher in ART cycles and because perinatal mortality rates are four to six times higher for MGP than singleton, MGP must be considered a serious complication of ART. This chapter presents the different aspects of early investigation and management of pregnancy failure and MGP, including sections on the clinical aspects of miscarriage, the ultrasound diagnosis of EPL and ectopic pregnancy, and the differential diagnosis between monozygotic and dizygotic twinning. The role of multifetal pregnancy reduction (MFPR) in the management of MGP resulting from ART is also discussed.

Clinicopathology and epidemiology of early pregnancy complications: definitions

Early pregnancy loss

This is defined as a miscarriage occurring within the first 12 weeks of gestation.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×