Home > Riviste > Minerva Obstetrics and Gynecology > Fascicoli precedenti > Minerva Ginecologica 2019 August;71(4):263-71 > Minerva Ginecologica 2019 August;71(4):281-7

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo
Share

 

ORIGINAL ARTICLE   

Minerva Ginecologica 2019 August;71(4):281-7

DOI: 10.23736/S0026-4784.19.04375-2

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Postpartum hemorrhage: not only hypertensive disorders in oocyte donation pregnancies

Caterina SERENA 1, Chiara COMITO 1 , Serena SIMEONE 1, Eleonora CAPANNINI 1, Nicola TOSI 2, Serena OTTANELLI 1, Marianna P. RAMBALDI 1, Maria E. COCCIA 3, Federico MECACCI 1, Felice PETRAGLIA 1

1 Division of Obstetrics and Gynecology, Department of Biomedical, Experimental, and Clinical Sciences, Careggi University Hospital, University of Florence, Florence, Italy; 2 Division of Urology, Department of General and Specialistic Surgery, Azienda Usl Toscana Sud-Est, Arezzo, Italy; 3 Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Department of Clinical and Experimental Biomedical Sciences, Careggi University Hospital, University of Florence, Florence, Italy



BACKGROUND: The aim of the study is to compare the obstetric outcome between single pregnancies obtained by medically-assisted procreation using oocyte donors (MAP-E) versus homologous gametes (MAP-O) and single spontaneous conception pregnancies (SC).
METHODS: This is a retrospective case-control study on pregnancy outcome of consecutive singleton live birth pregnancies from MAP-E between January 2011 and August 2017 referred to Careggi University Hospital, Florence. The control group includes singleton pregnancies from MAP-O and pregnancies from spontaneous conceptions in the same period. The pregnancy outcomes considered were: postpartum hemorrhage (PPH), cesarean section (CS), gestational diabetes mellitus (GDM), hypertensive disorders including preeclampsia (HDP), preterm birth ≤34 weeks (PTB), and small-for-gestational-age (SGA) fetuses.
RESULTS: The study group included 290 MAP-E pregnancies that were compared with 290 MAP-O and 870 singleton spontaneous conception pregnancies. The three groups did not show significant differences in maternal traits except for mean age (43.4±2.9 vs. 37.7±2.4 vs. 33.6±5.5, P<0.001), including a higher percentage of patients over 45 years (41.3% vs. 5% vs. 0.8%, P<0.001) and higher incidence of obesity (7.2% vs. 1.7%, P=0.02) in MAP-E than in MAP-O. The risk of HDP is increased in singleton pregnancies by oocyte donation with a significantly increased risk if compared to MAP-O (12% vs. 1%, P<0.001, OR=12.6). The risk of PPH in singleton pregnancies from oocyte donation is higher than in MAP-O (22% vs. 9% P<0.0001, OR=2.87). When we considered severe PPH (blood loss >1000 mL) the risk for MAP-E was higher if compared to MAP-O (OR=2.1, P=0.2) and mostly to SC (OR=14, P<0.005). Compared to SC, MAP-E pregnancies showed increased OR for all the outcomes: CS (78% vs. 30.8%, P<0.001, OR=7.91); GDM (26.1% vs. 10.8%, P<0.001, OR=2.92); HDP (12% vs. 2.2%, P<0.001, OR=5.99); PPH (22% vs. 8.5%, P<0.0001, OR=3.0); SGA (16% vs. 11%, P<0.05, OR=1.16); PTB ≤34 weeks (9.4% vs. 1%, P<0.001, OR=7.94).
CONCLUSIONS: Most women who undergo MAP-E are in advanced age, representing a high-risk population for obstetric complications, like HPD and PPH, which stands as the main worldwide cause of maternal mortality.


KEY WORDS: Postpartum hemorrhage; Oocyte donation; Assisted reproductive techniques; Maternal age

inizio pagina