OBSTETRIC OUTCOME OF NATURAL AND ASSISTED CONCEPTION TWIN PREGNANCIESIS SIMILAR

Background. The risk of obstetric intervention and adverse fetal or ne onatal outcome is considerably higher in multiple gestation than in si ngleton pregnancy. How assisted conception influences obstetric manage ment and outcome in twin pregnancies has not been evaluated. Methods. A survey of all twin pregnancies in Iceland and the Tayside Region, Sc otland for a four year period, 1990-93, comparing twins after assisted fertilization with natural conception. Results. The total number of t win pregnancies was 522, of which 453 were natural conceptions and 69 assisted. The twin rate was 1:75 among natural conceptions, but 1:5 in women having assisted fertilization. Mean gestational age in both gro ups was 36 weeks. Elective Cesarean section was used more often in the assisted conception group (odds ratio 2.57; p=0.003). Induction rates did not differ to any significant degree and once labor commenced, no difference was seen between assisted and natural conception twins in the mode of delivery or neonatal short term morbidity. Birthweight, ge stational length and perinatal mortality rates by conventional and ext ended classification were not different. Conclusion. After allowing fo r more frequent elective Cesarean section in the obstetric care of the assisted conception pregnancies, there was no major difference in obs tetric and neonatal management or outcome between twins resulting from natural and assisted conception.