Umbilical cord abnormalities in singleton pregnancies following assisted reproductive technologies (ART)

Abstract

OBJECTIVE: To determine if umbilical cord abnormalities differ in singleton pregnancies following assisted reproductive technologies (ART) compared to those from spontaneous pregnancies.DESIGN: Case-Control Study.MATERIALS AND METHODS: Outcome of all pregnancies from January 2001 to December 2005 were recorded in the McGill Obstetric and Neonatal Database (MOND). Umbilical cord features were noted at the time of delivery. All cords were subjected to histological examination. Singleton pregnancies derived from ART were compared with spontaneously conceived singleton pregnancies, matched for age and parity, and also with singleton pregnancies in couples with infertility who did not undergo ART.RESULTS: Umbilical cords from 468 singleton deliveries following ART were compared with those from 936 age- and parity-matched spontaneously conceived singleton deliveries and also with those from 202 singleton pregnancies in couples with infertility who did not undergo ART. Velamentous cord insertion was increased following ART (21/468 – 4.5%) when compared with matched controls (20/936 – 2.1%) and couples with a history of infertility who did not undergo ART (6/202 – 2.9%). The incidence of a single umbilical artery was also higher following ART (5/436) compared with matched controls (1/936) and infertility controls (0/202). There was no difference in the incidence of marginal cord insertion, cord twist, true knots, stenosis, thrombosis, cord length, nuchal cords, and prolapsed cord.CONCLUSIONS: We report a higher incidence of velamentous cord insertion and single umbilical artery in singleton pregnancies following ART. These results could be due in part to the techniques associated with ART or their underlying infertility. OBJECTIVE: To determine if umbilical cord abnormalities differ in singleton pregnancies following assisted reproductive technologies (ART) compared to those from spontaneous pregnancies. DESIGN: Case-Control Study. MATERIALS AND METHODS: Outcome of all pregnancies from January 2001 to December 2005 were recorded in the McGill Obstetric and Neonatal Database (MOND). Umbilical cord features were noted at the time of delivery. All cords were subjected to histological examination. Singleton pregnancies derived from ART were compared with spontaneously conceived singleton pregnancies, matched for age and parity, and also with singleton pregnancies in couples with infertility who did not undergo ART. RESULTS: Umbilical cords from 468 singleton deliveries following ART were compared with those from 936 age- and parity-matched spontaneously conceived singleton deliveries and also with those from 202 singleton pregnancies in couples with infertility who did not undergo ART. Velamentous cord insertion was increased following ART (21/468 – 4.5%) when compared with matched controls (20/936 – 2.1%) and couples with a history of infertility who did not undergo ART (6/202 – 2.9%). The incidence of a single umbilical artery was also higher following ART (5/436) compared with matched controls (1/936) and infertility controls (0/202). There was no difference in the incidence of marginal cord insertion, cord twist, true knots, stenosis, thrombosis, cord length, nuchal cords, and prolapsed cord. CONCLUSIONS: We report a higher incidence of velamentous cord insertion and single umbilical artery in singleton pregnancies following ART. These results could be due in part to the techniques associated with ART or their underlying infertility.