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Abstract：
OBJECTIVE: This study aimed to determine the third-stage complications and their risk factors in in vitro fertilization (IVF) pregnancies.
METHODS: This prospective observational study was conducted from March 2022 to November 2023 at a tertiary care university hospital in South India. We included a total of 217 women following IVF conception, and details of the third-stage labor complications were documented and expressed as the frequency with percentage. The risk factors were analyzed using a logistic regression model.
RESULTS: Among 217 participants, 51 (23.5%) had third-stage complications. Postpartum hemorrhage (PPH) was the most common, complicating 20% of the deliveries. Multiple gestations (adjusted odds ratio (aOR) 2.7, 95% confidence interval (CI) 1.03-7.46, p = 0.04), operative vaginal delivery (aOR 57, 95% CI 4.2-770, p = 0.002), and emergency cesarean section (aOR 14.8, 95% CI 1.3-160.5, p = 0.026) were the risk factors for PPH. Intrapartum infection was found to be associated with a risk for the retained placenta (aOR 8, 95% CI 1.37-46.4, p = 0.02) and adherent placenta (aOR 6.06, 95% CI 1.07-34.3, p = 0.04). Assisted reproductive technology (ART)-related factors were not found to be significantly associated with third-stage complications.
CONCLUSIONS: There is a risk of third-stage complications, especially postpartum hemorrhage, among IVF pregnancies. The type of embryo transfer was not associated with third-stage complications.
METHODS: This prospective observational study was conducted from March 2022 to November 2023 at a tertiary care university hospital in South India. We included a total of 217 women following IVF conception, and details of the third-stage labor complications were documented and expressed as the frequency with percentage. The risk factors were analyzed using a logistic regression model.
RESULTS: Among 217 participants, 51 (23.5%) had third-stage complications. Postpartum hemorrhage (PPH) was the most common, complicating 20% of the deliveries. Multiple gestations (adjusted odds ratio (aOR) 2.7, 95% confidence interval (CI) 1.03-7.46, p = 0.04), operative vaginal delivery (aOR 57, 95% CI 4.2-770, p = 0.002), and emergency cesarean section (aOR 14.8, 95% CI 1.3-160.5, p = 0.026) were the risk factors for PPH. Intrapartum infection was found to be associated with a risk for the retained placenta (aOR 8, 95% CI 1.37-46.4, p = 0.02) and adherent placenta (aOR 6.06, 95% CI 1.07-34.3, p = 0.04). Assisted reproductive technology (ART)-related factors were not found to be significantly associated with third-stage complications.
CONCLUSIONS: There is a risk of third-stage complications, especially postpartum hemorrhage, among IVF pregnancies. The type of embryo transfer was not associated with third-stage complications.
摘要：
目的：本研究旨在确定体外受精（IVF）妊娠的第三阶段并发症及其危险因素。
方法：这项前瞻性观察性研究于2022年3月至2023年11月在印度南部的一所三级护理大学医院进行。我们纳入了总共217名试管婴儿受孕后的女性，记录第三期分娩并发症的详细信息,并以频率和百分比表示.采用Logistic回归模型对危险因素进行分析。
结果：在217名参与者中，51例（23.5%）出现第三阶段并发症。产后出血（PPH）是最常见的，使20%的交付复杂化。多胎妊娠（调整比值比（AOR）2.7，95％置信区间（CI）1.03-7.46，p=0.04），手术阴道分娩（aOR57，95%CI4.2-770，p=0.002），和紧急剖宫产（aOR14.8，95％CI1.3-160.5，p=0.026）是PPH的危险因素。发现产时感染与胎盘保留（aOR8，95％CI1.37-46.4，p=0.02）和胎盘贴壁（aOR6.06，95％CI1.07-34.3，p=0.04）的风险相关。辅助生殖技术（ART）相关因素未发现与第三阶段并发症显着相关。
结论：有第三阶段并发症的风险，尤其是产后出血,在IVF怀孕中。胚胎移植的类型与第三阶段并发症无关。
方法：这项前瞻性观察性研究于2022年3月至2023年11月在印度南部的一所三级护理大学医院进行。我们纳入了总共217名试管婴儿受孕后的女性，记录第三期分娩并发症的详细信息,并以频率和百分比表示.采用Logistic回归模型对危险因素进行分析。
结果：在217名参与者中，51例（23.5%）出现第三阶段并发症。产后出血（PPH）是最常见的，使20%的交付复杂化。多胎妊娠（调整比值比（AOR）2.7，95％置信区间（CI）1.03-7.46，p=0.04），手术阴道分娩（aOR57，95%CI4.2-770，p=0.002），和紧急剖宫产（aOR14.8，95％CI1.3-160.5，p=0.026）是PPH的危险因素。发现产时感染与胎盘保留（aOR8，95％CI1.37-46.4，p=0.02）和胎盘贴壁（aOR6.06，95％CI1.07-34.3，p=0.04）的风险相关。辅助生殖技术（ART）相关因素未发现与第三阶段并发症显着相关。
结论：有第三阶段并发症的风险，尤其是产后出血,在IVF怀孕中。胚胎移植的类型与第三阶段并发症无关。
