title: Iatrogenic multiple pregnancy. Higher risk than a spontaneous one?
abstract: OBJECTIVE
  To determine if spontaneous and induced multiple pregnancies have similar outcomes.
  
  
  METHODS
  We compared the results of antepartum and intrapartum surveillance and fetal outcome in spontaneous multiple gestations (group A) with induced multiple gestations (group B) at Albert Szent-Györgyi Medical University, Szeged, Hungary, in a six-year period.
  
  
  RESULTS
  Between January 1, 1991, and December 31, 1996, there were 13,131 births; the number of multiple pregnancies was 307 (2.34%). There were 232 spontaneous and 48 induced twin pregnancies, 8 spontaneous and 16 induced triplet pregnancies, and 3 quadruplet pregnancies, all induced. Higher incidences of gestational diabetes and cervical insufficiency were found in group B. The incidences of prematurity in the induced and spontaneous groups were similar. The incidences of low birth weight and perinatal mortality were higher in induced triplet pregnancies than in spontaneous ones. Fetal outcome, with respect to Apgar score and umbilical cord blood pH, was much poorer in both induced groups.
  
  
  CONCLUSIONS
  Iatrogenic multiple pregnancy following ovulation induction or assisted operative reproductive techniques may increase the incidence of pathologic events in the antepartum, intrapartum or postpartum period. Careful counseling before assisted reproductive techniques is of paramount importance.
authors.affiliation: Department of Obstetrics and Gynaecology, Albert Szent-Györgyi Medical University, Szeged, Hungary.
authors.forename: I
authors.initials: I
authors.lastname: Nyirati
authors.forename: H
authors.initials: H
authors.lastname: Orvos
authors.forename: G
authors.initials: G
authors.lastname: Bártfai
authors.forename: L
authors.initials: L
authors.lastname: Kovács
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D012099:Reproductive Techniques / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors