تاثير التقنيات المساعدة على الانجاب على نتاج الحمل في مستشفيات بغداد : دراسة مقارنة == Impact of Assisted Reproductive Technology On Pregnancy Outcome In Baghdad Hospitals : Comparative Study
Author name:
رغد زغير دوسر
Supervisor name:
عز الدين فخر الدين بهاء الدين
Abstract:
الخلفية : في عام1978 ولادة الطفل الاول في المملكة المتحدة من قبل تقنيات المساعدة على الانجاب، ازداد كلا من التقنيات المتطورة التي تستخدم لعلاج العقم وعدد مراكز الاخصاب التي توفر خدمات التقنيات المساعدة على الانجاب بشكل كبير في كثير من البلدان,وتشمل التقنيا | Background : In 1978 the first baby born in the U.K by the techniques of assisted reproduction. both the use of advanced technologies to overcome infertility and the number of fertility clinics providing ART services have increased steadily in many countries. ART includes fertility treatments in which both eggs and sperm are handled in the laboratory (in vitro fertilization (IVF), intra cytoplasmic sperm injection (ICSI), gamete intrafallopian transfer (GIFT), zygote intrafalopian transfer(ZIFT), and related procedures). Women who undergo ART procedures are more likely to deliver multiple - birth infants than those who conceive naturally because more than one embryo might be transferred during a procedure. Multiple births pose substantial risks to both mothers and infants, including pregnancy complications like, preterm delivery, and low birth weight infants. Caesarean section, pregnancy induce hypertension, gestational diabetes, congenital malformation.Objective : To assess the impact of assisted reproductive technology on pregnancy outcome and compare them to those of natural conception. Methodology : The present study employs a descriptive - purposive design carried out for pregnant women after assisted reproductive technology attending labor wards of Baghdad Hospitals, Kamal AL - samarae Hospital, Baghdad Teaching Hospital, AL Imamain AL - Kadhmien Teaching Hospital, Private Nursing House Hospital, AL - Elwya Maternity Teaching Hospital, AL Imam Ali Hospital, AL - Karkh Maternity Hospital for, and Ibn AL Baladi Hospital. The period for collecting the data was four months (1st February 2014 to the 1st Jun 2014). The study sample divided into two groups : 100 women conceived after assisted reproductive technology(study group), 100 women conceived naturally (control group). Validity through a panel of (15) experts and the reliability of the questionnaire is determined through the pilot study. For the purpose of the present study a questionnaire format was constructed. The data has been managed and analyzed by using descriptive and inferential statistics. Results : An increased pregnancy complication as well as higher risk of obstetrical, perinatal, and neonatal complications was observed in ART compared with natural pregnancy included in this study. The women conceived by ART were older than those conceived naturally (30.86_+ 4.76 vs 25.85 - +7.78) ART pregnancies were associated with a higher risk of early pregnancy bleeding (8% vs 42%), antepartum heamorrhage (4% vs 13%), placenta previa (6% vs 15%), pregnancy - induced hypertension (29% vs 46%), gestational diabetes (7% vs 20%), preterm rupture of membrane (11% vs 25%), preeclampsia (3% vs 12%), obesity during pregnancy (47% vs 65% ), preterm delivery (16% vs 48%), cesarean section( 67% vs 100%), low birth weight (12% vs 32.5%), multiple birth (twin 11% and twin tri 7% vs.0.0%), the period of the newborn child stay in the neonatal intensive care unit (15 days 47.8% vs. 0.0%)Conclusion : The pregnancies after ART are associated with higher risk of multiple pregnancies, obstetrical, perinatal, as well as neonatal complications in comparison with natural pregnancy. Recommendations : Educate mothers who become pregnant using the techniques of assisted reproduction importance they received of their children examined periodically, with long - term developmental follow - up on a regular basis, to exclude late complication of the pregnancy outcome. Emphasis should be on the birth of healthy infants primarily using Embryo single transfer (EST),to reduce the incidence of low birth weight and preterm delivery.
