Comparison of Third stage complications between fresh and frozen embryo transfer pregnancies - An analytical Cohort study

The third stage of Labour begins from the delivery of the baby to the expulsion of the placenta and membranes. There are 3 distinct phases of the Third stage of labour; strong uterine muscle contraction, expulsion phase and uterine vessel contraction phase. Active management of the third stage of labour(AMTSL) is advocated as a prophylactic measure to decrease the postpartum haemorrhage.

Globally, there is an increase in the utilisation of Assisted Reproductive Technologies (ART) among infertile couples. Similar growth in ART clinics and cycles has been recorded in India as per the National ART registry.With advances in the quality and efficacy of the techniques, the conception rate following ART (OI, IUI, IVF, ICSI) has increased significantly. The high prevalence of multiple pregnancies being most commonly associated with these techniques increases adverse maternal and perinatal outcomes. Most of the retrospective cohort studies have observed similar complications even in singleton pregnancy following ART as compared to spontaneous conceptions.

Most of the previous literature has focussed on composite adverse pregnancy outcomes in these conceptions. From the previous studies, it has been shown that ART is associated with increased third stage complications like increased duration, morbidly adherent placenta, and manual removal of placenta, PPH, blood transfusion and ICU admission.

There is a lacuna in Indian data with respect to third stage outcomes specific to various ART.

If the study results show specific complications with regard to techniques, a focused approach for predicting third stage complications can be advocated to prevent morbidity and mortality.