Obstetric and perinatal outcomes of monochorionic pregnancy

Abstract

The objective. We aimed to study obstetric and perinatal outcomes in multiple pregnancies, depending on the type of choriality. Materials and methods. We used a retrospective analysis of the birth histories. 174 women with spontaneously occurring multiple pregnancies were involved in the study. There were 50 women with monochorionic placentation and 120 women with a dichorionic type of placentation. We analyzed the course of pregnancy, parturition and perinatal outcomes in these patients. The data were processed using parametric and nonparametric statistics. Results. Mean age of women was comparable and amounted to 28.5 ± 5.4 in women with monochorionic pregnancy and 29.4 ± 5.1 with dichorionic pregnancy. Both groups were comparable in social status, place of residence and parity. The risk of placental disorders (OR 2.9; 95% CI 1.4-5.7), fetal growth retardation (OR 2.4; 95% CI 1.1-5.4), gestational diabetes (Or 4,24; 95% CI 1.5-11.7), premature birth (OR 2.3; 95% CI 1.3-3.9), premature delivery at 34-36 weeks (OR 2.7; 95% CI 1.4-5.3), operative parturitions (OR 3.54; 95% CI 1.4-8.4), discordance of fetuses (OR 3.2; 95% CI 1.5-7.1) were higher in monochorionic multiple pregnancy. Prematurity (ОR 4.6; 95% CI 2.8-7.4) and low weight by gestational age (ОR 2.0; 95% CI 1,1-3.5) were the leading diagnosis in newborns who were born from monochorionic pregnancy. Conclusions. It is necessary to continue researches on this problem and develop guidelines for the management of women with monochorionic and dichorionic forms of placentation.

Keywords

• monochorionic pregnancy
• dichorionic pregnancy
• complications of pregnancy
• perinatal outcomes