Clinical and statistical analysis of obstetric and perinatal complications in pregnant women with an allogeneic fetus
DOI:
https://doi.org/10.15574/HW.2022.161.32Keywords:
assisted reproductive technologies, in vitro fertilization, allogenous fetus, immune tolerance, oocyte donation, surrogacy, obstetric complications, perinatal outcomes, fetoplacental complexAbstract
Deterioration of women’s reproductive health causes an increase in the general number of oocyte donation and surrogacy programs. The formation of an allogeneic fetus in such cases affects the course of implantation and placentation, which is reflected in the increased frequency of obstetric and perinatal complications. The psychological status of these patients also has a significant impact on the course of pregnancy, childbirth and the postpartum period, which differs from that of women who are carrying their own child and/or have undergone infertility treatment.
Purpose - to perform a comparative clinical and statistical analysis of somatic and reproductive history, obstetric and perinatal complications in pregnant women with an allogeneic fetus and pregnant women who were involved in in vitro fertilization (IVF) programs with their own oocytes.
Materials and methods. Clinical and statistical analysis of the medical records of 200 patients, who were divided into two groups, was performed: the Group I - 150 pregnant women who were involved in IVF programs with the formation of an allogeneic fetus; the Group II (control) - 50 pregnant women who underwent IVF using the woman's own oocytes.
Results. Among patients with an allogeneic fetus, a significantly lower number of various complications of somatic and reproductive anamnesis were recorded. The rates of obstetric and perinatal complications were comparable or higher as in the control group; the criteria for statistical significance of the difference were fulfilled for the indicators of gestational anemia, which was more often registered in the main group. The proportion of deliveries by caesarean section was significantly lower among pregnant women with an allogeneic fetus. The average weight of the newborn of the main group was significantly lower compared to the control.
Conclusions. Despite the significantly lower frequency of detection of factors aggravating somatic and reproductive anamnesis, patients with an allogeneic fetus are characterized by comparable or higher rates of obstetric and perinatal complications, which makes it necessary to provide further investigation of the potential causes of this phenomenon, the features of the functioning of the fetoplacental complex, and the influence of the psychological status of the patients in order to improve the algorithm of pregravid preparation and antenatal surveillance.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
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