In Vitro Fertilization Unit, The Edith Wolfson Medical Center, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Matern Fetal Neonatal Med. 2023 Dec;36(1):2221763. doi: 10.1080/14767058.2023.2221763.
-fertilization (IVF) is an independent risk factor for placenta previa (PP). Our aim was to study this link by comparing the clinical characteristics and placental histology of pregnancies complicated by PP in IVF versus unassisted pregnancies.
A retrospective-cohort study of deliveries with PP between 2008 and 2021. Placental histology, obstetric and neonatal outcomes were compared between IVF and unassisted pregnancies. Included, were singleton deliveries complicated by PP at gestational weeks (GA) >24.
A total of 182 pregnancies were included - 23 IVF pregnancies (IVF group) and 159 unassisted pregnancies (Control group). The control group was characterized by higher gravidity ( = .007) and parity ( < .001) and a trend of more past cesarean deliveries, whereas the IVF group- by a higher rate of nulliparity ( < .001) and diabetes mellitus ( = .04). The control group was characterized by a higher rate of placental weight below the 10th percentile (47.8 versus 13.9%, = .001) and by a trend of a lower overall placental weight. No differences were noted in maternal and fetal vascular lesions.
While PP in non-assisted pregnancies is probably associated with previous CDs, in IVF it is more "sporadic," and may complicate any index pregnancy. A lower placental weight was more prevalent in the control group, supporting the concept that pregnancies complicated by PP following IVF can be attributed to initial abnormal location of placentation, rather than an underlying pathological uterine segment of implantation. Nevertheless, IVF and unassisted pregnancies entail similar perinatal outcomes in cases of PP.
-受精（IVF）是前置胎盘（PP）的独立危险因素。我们的目的是通过比较 IVF 与非辅助妊娠中 PP 合并妊娠的临床特征和胎盘组织学来研究这种联系。
对 2008 年至 2021 年期间发生的 PP 进行回顾性队列研究。比较 IVF 和非辅助妊娠中 PP 合并妊娠的胎盘组织学、产科和新生儿结局。包括 24 周以上妊娠周数（GA）的单胎分娩并发 PP。
共纳入 182 例妊娠，其中 23 例为 IVF 妊娠（IVF 组），159 例为非辅助妊娠（对照组）。对照组的特征是更高的孕次（=0.007）和产次（<0.001），以及更多的既往剖宫产史趋势，而 IVF 组则以更高的初产妇比例（<0.001）和糖尿病发生率（=0.04）为特征。对照组的胎盘重量低于第 10 百分位数的比例更高（47.8%比 13.9%，=0.001），且总体胎盘重量呈下降趋势。在母体和胎儿血管病变方面无差异。
虽然非辅助妊娠中的 PP 可能与既往 CD 有关，但在 IVF 中，它更具“散发性”，可能会使任何指数妊娠复杂化。对照组中较低的胎盘重量更为常见，支持这样一种观点，即 IVF 后发生的 PP 妊娠可归因于初始胎盘着床位置异常，而不是植入的潜在病理性子宫段。然而，在 PP 病例中，IVF 和非辅助妊娠的围产期结局相似。
