Gynecology & Obstetrics
Open Access
ISSN: 2161-0932
ISSN: 2161-0932
Astrit M.Gashi, Shqipe Fetiu and Mejreme Ramosaj
Aim: The purpose of this research is to determine the incidence of high order multiple pregnancies in Kosovo, and the impact of assisted reproductive technology in the growth of this incidence.
Material and Methods: We conducted a retrospective analysis of database for births during 10 years (2003-2013), in Obstetrics and Gynecology Clinic/University Clinical Centre of Kosovo. The focus of this research is to determine the incidence of high order multiple pregnancies in Kosovo, that represented from triplet pregnancies.
Maternal characteristics such as: average maternal age, average gestational age, the average weight at births and mode of delivery, were recorded. Are also recorded and: method of conception, and Apgar test scoring. Statistical analysis was performed using the computer prog for statistics. Sum tests were used to compare differences in categorical variables. Number of all women who had births during 2 years (2003 and 2013) was used to compute rates for this study.
Results: From 10,286 the realized births in GOC during 2013, 97.22% (n=10,000) were singleton pregnancies, 2.78% (n=286) multiple pregnancies, of these 2.63% (n=270) twins, 0.15% (n=16) triplet pregnancy, there was not quadruplet pregnancy.
The focus of this research is to determine the incidence of high order multiple pregnancies in Kosovo, that represented from triplet pregnancies. By the method of conception: 50% (n=8) were triplets pregnancies that are realized by the use of ART, while 50% (n=8) with spontaneous conception (due to unsafe system of reporting in the latter group are introduced triplet pregnancies realized by the use of medications for ovulations). The average maternal age with triplet pregnancies resulted to be 33.3 years old, while the average gestational age at birth was 31.9 weeks pregnant, although 12.5% were born before gestational week 28, 25% before 32 weeks, 62.5% were born in the middle of the week 32-35 gestation. From 16 triplets pregnancies: 87.5% the born with caesarean delivery, 12.5% vaginal delivery (vaginal delivery were emergency, with pregnant age ≤ 25 gestational weeks and weight ≤ 700 g). Average weight at births of all triplets was 1775.4 g, where 27.08% are born with less than 1500 g, 58.34% ≤ 2500 g, and 14:58% ≥ 2500 g. The Apgar test scoring for all triplets was between 5 and 6. All these results were compared with data from 2003 (the year that officially started ART in Kosovo) where the 11,065 births in GOC the realized during 2003, 98.2% (n=10,856) were singleton pregnancies, 1.88% (n=209) multiple pregnancies, of these 1.86% (n=206) twins, 0.02% (n=3) triplet pregnancies, there was not quadruplet pregnancy. From total of three triplet pregnancy: 1 was realized with the use of ART, 2 others with spontaneous conception. The average maternal age with triplet pregnancies was 29.3 years old, while the average gestational age at birth was 31.9 weeks pregnant. From 3 triplet pregnancies: 66.7% the born with caesarean delivery, 33.3% with vaginal delivery. The birth weight averages of all triplets was 1422 g, the Apgar test scoring for all triplets was between 4 and 5.
Conclusions: From this study resulted that the incidence of high order multiple pregnancies represented by triplets pregnancies in Kosovo during 2013 was 0.15% or in ratio 155.5 triplets for 100,000 births. This incidence was increased to 50% more by the use of assisted reproduction technology for conception. It is observed that the increase of the high order multiple pregnancies also affects old maternal age.
Low weight at birth, and early gestational age of birth of these triplet pregnancy, affect the increased of perinatal morbidity and mortality from complications of fetal prematurity. When it became comparison between year 2003 and year 2013, a time interval of 10 years turned out that the incidence of triplet pregnancies, is increased to 5.7 times more.