Pregnancy Management after ART
Since 1978, we have had about 8 million pregnancies by ART and considering this important increase in the use of ART worldwide. It will be extremely important to assess the potential health risk for the offspring both in the short term and in the long term. So we know that pregnancy outcomes after ART have an increased incidence of several obstetric and perinatal complications mainly because of the high incidence of multiple gestations. Even singleton pregnancies are nowadays associated with increased incidence of complications and we should not forget about the maternal age because the majority of the ART pregnancies have an advanced maternal age which comes with its own basket of complications.
We have to come out with a consensus of an appropriate prenatal protocol for IVF conceived pregnancies and we should not forget that these are special pregnancies that need special care as they may not have the next better option. So our objectives today start from as early as a pre-pregnancy optimization to screening through pregnancies that are morbidities, look out for preterm deliveries, aneuploidies, and breastfeeding.
Now nutrition forms a very important part of preconception care especially in countries like India wherein obstetricians should focus on the daily intake of fruits, vegetables, and daily multivitamins to bring about a good source of antioxidants. Female pre-pregnancy folic acid supplementation should be encouraged to reduce the risk of neural tube defects and you should screen for recommended daily allowances for iron, vitamin B12, D, other nutrients and do the needful correction in the pre-conceptional period itself. Folic acid is known to be critical in the one-carbon metabolism to provide methyl groups for methylation and there is now enough evidence to suggest that folate deficiency can induce neonatal neural tube defects and as a result of which WHO and now practically all institutions recommend a periconceptional maternal folic acid supplementation for preventing these defects
You can find out more details by enrolling in Pregnancy Management after ART - Is it different? lecture by Dr. Garima Sharma (MS, DNB OBGY, FRM) & Dr. Aditi Trivedi (DNB OBGY, FRM) here,https://docmode.org/pregnancy-management-after-art-is-it-different-26-june-2021/
