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Fetal Complications During Pregnancy

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Clinical Management of Pregnancies following ART

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Abstract

There have now been over five million births worldwide following the use of assisted reproductive technology (ART) and the rates of assisted conceptions continue to rise. Hence any increase in adverse fetal outcomes resulting from the use of this technology constitutes a significant public health issue. While some perinatal complications are more common in fetuses conceived using ART, difficulties arise in many studies with defining the risk of complications that is attributable to the process of ART itself. There are a number of important confounding factors that may well contribute to adverse outcomes including the high incidence of multiple pregnancies, the reasons for the underlying subfertility, poor gamete quality, and advanced maternal age. Fetal complications that are more common in pregnancies conceived using ART arise via a number of distinct mechanisms. There are those derived from the conceptus itself, which include chromosomal, genetic and imprinted disorders that can impact on fetal development. There are those that arise from placental anomalies, leading to iatrogenic preterm delivery particularly placenta praevia. The most common group of disorders are those that arise from an interplay of fetal, maternal and placental factors including preterm delivery, intrauterine growth restriction, pre-eclampsia, and perinatal death. Regardless of whether these are direct consequences of the use of ART or are merely associated through other indirect factors such as maternal age, conception after ART should be a factor that alerts the clinician to the possibility of fetal complications during pregnancy.

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Authors and Affiliations

  1. Department of Fetal and Maternal Medicine, Addenbrooke’s Hospital, Cambridge, UK

    Catherine E. M. Aiken PhD, MRCP, MRCOG

  2. Department of Obstetrics and Gynaecology, Cambridge University Hospitals NHS Trust, Cambridge, UK

    Jeremy Brockelsby MBBS, PhD, MRCOG

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  1. Catherine E. M. Aiken PhD, MRCP, MRCOG
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  2. Jeremy Brockelsby MBBS, PhD, MRCOG
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Correspondence to Jeremy Brockelsby MBBS, PhD, MRCOG .

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Editors and Affiliations

  1. Department of Maternity and Gynaecology, Royal Derby Hospital, University of Nottingham, Derby, United Kingdom

    Kanna Jayaprakasan

  2. Department of Obstetrics, Nottingham University Hospitals, Nottingham, United Kingdom

    Lucy Kean

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Aiken, C.E.M., Brockelsby, J. (2017). Fetal Complications During Pregnancy. In: Jayaprakasan, K., Kean, L. (eds) Clinical Management of Pregnancies following ART. Springer, Cham. https://doi.org/10.1007/978-3-319-42858-1_10

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  • DOI: https://doi.org/10.1007/978-3-319-42858-1_10

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