Pregnancy Management in In Vitro Patients

What are the significant risk factors during pregnancy after using assisted reproductive technologies are: hypercoagulation, placental abruption, premature detachment of a normally located placenta, gestational hypertension and preeclampsia, premature birth, etc.

The laboratory psycho-emotional state of a pregnant woman can also be one of the components of obstetric complications.
A complicated pregnancy after IVF is associated with:
– increased hormonal load;
– sometimes the transfer of 2 or more embryos;
– in some cases, activation of viral-bacterial infection;
– placental insufficiency;
– thrombophilic states.
More than 50% of pregnant women after embryo transfer face the problem of pregnancy loss, most of which occur in the first trimester, the so-called early losses.
On average, the risk of miscarriage in the first trimester after IVF is 35%-80%. The incidence of spontaneous abortions is 20-45%, and premature birth is 20% to 35%.
Changes in the hemostasis system lead to the development of placental insufficiency and preeclampsia in this category of pregnant women.
So, after IVF the incidence of preeclampsia is 40%;

Prevention of preeclampsia:

• Aspirin (150 mg/day);
• Antiplatelet agents during preparation and during pregnancy;
• Vitamin D;
• Calcium supplements.
Given the increased risk, it is advisable to expand the usual protocols for diagnosing defects (preimplantation genetic diagnosis of the embryo, non-invasive prenatal screening – NIPT, or 16 – 20 weeks – amniocentesis, prenatal screening ASTRAIA.
Pregnancy after IVF is accompanied by a large number of obstetric complications.
Pregnant women after IVF should initially be classified as at risk of miscarriage.
A thorough anamnesis collected during registration of pregnant women after IVF, monitoring of cervical length, timely detection of psychological problems and their correction can improve gestational and perinatal outcomes.

Dr. Tea Kolbaia

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