IMR Press / CEOG / Volume 48 / Issue 3 / DOI: 10.31083/j.ceog.2021.03.2450
Open Access Original Research
Perinatal outcome in twins. A hospital based comparative study at a single third-level care centre in Croatia
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1 Department of Obstetrics and Gynaecology, General Hospital Virovitica, 33000 Virovitica, Croatia
2 Department of Obstetrics and Gynaecology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
3 School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
4 Department of Obstetrics and Gynaecology, Clinical Hospital ‘Sveti Duh’, 10000 Zagreb, Croatia
5 Department of Obstetrics and Gynaecology, General Hospital Karlovac, 47000 Karlovac, Croatia
6 School of Medicine, Catholic University of Croatia, 10000 Zagreb, Croatia
*Correspondence: (Dino Pavoković); (Vesna Elveđi Gašparović)
These authors contributed equally.
Clin. Exp. Obstet. Gynecol. 2021, 48(3), 631–636;
Submitted: 4 January 2021 | Revised: 22 February 2021 | Accepted: 4 March 2021 | Published: 15 June 2021
(This article belongs to the Special Issue Caesarean Section Today - “Caesarology in the 21st Century”)
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (

Background: The goal of our study is to explore the association of assisted reproductive technology (ART) as contributing factor for obstetric complications and perinatal outcome in twin pregnancies during a 14-year period at a single tertiary centre. Methods: We collected the data (from maternal and neonatal medical records) from 731 twin pregnancies; 192 conceived by ART and 539 twin pregnancies conceived naturally during a 14-year period. Results: Pregnancy complications in twin pregnancies mainly included preterm premature rupture of membranes, gestational diabetes mellitus, and preeclampsia. Higher occurrence of placenta praevia in the ART group was the only perinatal risk related to twin pregnancies in the ART group as compared to those conceived naturally. Over 71% of ART twins were delivered by caesarean section, which is considerably increased as compared to non-ART twins (p = 0.042). Neonatal complications in both groups mainly included low Apgar score in the 1st minute, low birth weight and admission to NICU, and the incidences of these complications were comparable between the groups. Conclusion: Our results indicated that ART procedures were not followed by adverse obstetric and perinatal outcome in twin pregnancy delivered at single tertiary centre, except for the slightly higher risk of placenta praevia.

Twin pregnancy
Assisted reproductive technology
Obstetric complications
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