Late termination of pregnancy due to fetal abnormalities: An analysis of 229 cases

Tayyar, Ahmet; Açar, Deniz; Turhan, Uğur; Özköse, Zeynep Gedik; Ekiz, Ali; Gezdırıcı, Alper; Güleç, Elif Yılmaz; Polat, İbrahim

doi:10.5222/iksst.2018.023

Cited by 4 publications

(7 citation statements)

References 14 publications

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“…[1,4,[10][11][12][13][14] Also, Down syndrome is the leading indication in the terminations with chromosomal anomaly indication, which is consistent with the literature. [1,12,14,15] This can be explained with the higher rate of diagnosing trisomy 21 in the countries carrying out national screening program during first trimester as in Turkey. [12,16] Vaknin et al performed karyotype assay in 71.4% of their cases in their study while this rate was 29.6% in our study group.…”

Section: Discussionsupporting

confidence: 90%

“…[1,12,14,15] This can be explained with the higher rate of diagnosing trisomy 21 in the countries carrying out national screening program during first trimester as in Turkey. [12,16] Vaknin et al performed karyotype assay in 71.4% of their cases in their study while this rate was 29.6% in our study group. Lower rate of diagnosing chromosomal anomalies in our study may be associated with the low rate of performing karyotype analysis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The analysis of the termination of pregnancies at and after ten weeks of gestation – a monocenter study

Baran¹,

Alemdaroğlu²,

Durdağ³

et al. 2019

Perinatal J

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On hafta ve üzeri gebelik terminasyonlar›n›n analizi-Tek merkezli çal›flma Amaç: Klini¤imizde yap›lm›fl olan 10 hafta ve üzeri gebelik termi-nasyonlar›n›n endikasyonlar›n› ve obstetrik özelliklerini inceleyerek, bu olgular› daha iyi yönetebilmeyi ve do¤ru yaklafl›mlar› gelifltirebilmeyi amaçlad›k. Yöntem: Ocak 2012-Ocak 2019 aras›nda klini¤imizde gerçekleflmifl 379 terminasyon olgusunun maternal verileri, obstetrik özellikleri ve endikasyonlar› de¤erlendirildi. Endikasyonlar; maternal nedenler, amniyotik s›v› anomalileri, izole yap›sal, çoklu konjenital ve genetik bozukluklar olarak grupland›r›ld›. Gruplar özelliklerine göre s›n›fland›r›ld› ve kendi aralar›nda karfl›laflt›r›ld›. Bulgular: Ortalama yafl 30.2±6, ortalama gebelik haftas› 17.4±3.5, ortalama terminasyon süresi 16.4±14.5 saatti. En s›k amniyotik s›-v› anomalileri nedeniyle terminasyon yap›ld›¤› izlendi (n=126, %33.2). Fetal nedenler içerisinde en s›k izole yap›sal anomaliler (n=114, %30.1) tespit edildi. Santral sinir sistemi anomalileri en çok görülen izole yap›sal anomaliler idi (n=60, %15.8). Terminas-yonlar›n 25/379'u (%6.6) maternal nedenli idi. Genetik bozukluklar için invaziv tetkik istenme oran› %49.6 (n=197), yap›lma oran› %31.7 (n=120) idi. En s›k trizomi 21 (n=39, %55.7) olmak üzere kromozomal anomali 69 (%18.2) olguda tespit edildi. Kromozomal anomalilerin daha ileri maternal yafl ve daha erken gebelik haf-talar›nda tespit edildi¤i izlendi. ‹zole yap›sal ve çoklu konjenital anomalilerin ise daha genç yaflta ve daha ileri gebelik haftalar›nda saptand›¤› görüldü (özellikle kardiyak ve ürogenital anomaliler) (maternal yafl, p=0.002; gebelik haftas›, p<0.001). Sonuç: Terminasyon olgular›n›n yönetiminde fetal ve maternal nedenlerin ve terminasyon komplikasyonlar›n›n analizi, takip eden gebeliklerin tan› ve terminasyon süreçlerinin yönetiminde örnek olacakt›r. Gebelik terminasyonlar›n›n etik, psikolojik, ekonomik ve yasal boyutlar›n›n dikkate al›nmas›, aile ile hekim iflbirli¤i içerisinde bu konuda standart yaklafl›mlar›n oluflturulmas›nda etkili olaca¤› görüflündeyiz.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

The analysis of the termination of pregnancies at and after ten weeks of gestation – a monocenter study

Baran¹,

Alemdaroğlu²,

Durdağ³

et al. 2019

Perinatal J

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show abstract

“…Fetal anomalies are one of the leading causes of infant deaths and termination of pregnancy due to fetal anomaly is legally performed in many countries including Turkey ( 3 ). Diagnosis rates of fetal anomalies are likely to increase with the introduction of non-invasive prenatal screening tests, allowing the earlier detection rate of prenatal diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Perinatal Grief and Related Factors After Termination of Pregnancy for Fetal Anomaly: One-Year Follow-up Study

Güçlü¹,

Şenormancı²,

Tüten³

et al. 2021

Archives of Neuropsychiatry

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Introduction: Many people grieve in a resilient manner, often having a sense of equilibrium restored within six months. The most devastating type of loss is usually considered to be the death of the child. For such a loss, bereavement may take a period of distressing years with signs and symptoms that are related to grief. There have been different phases identified in the grieving process, and this process encompasses various difficulties with different levels of psychological effects. Women with perinatal losses can suffer long periods of grief. The purpose of this study was to monitor the grief in women who had undergone a termination of pregnancy due to fetal anomaly. Methods: Forty-six women who applied to the Gynaecology Clinic of Istanbul University Cerrahpaşa Faculty of Medicine and who decided to terminate their pregnancy due to fetal anomaly were included in the study. The Perinatal Grief Scale (PGS), the Impact of Event Scale-Revised (IES-R), Beck Anxiety Inventory (BAI), the Edinburgh Postnatal Depression Scale (EPDS), the Multidimensional Relationship Questionnaire (MRQ) and the Adult Attachment Scale (AAS) were administered to the participants six weeks after termination. Participants’ grief signs were re-evaluated with the PGS at the sixth and 12th months. Results: There was no relationship between severity of grief symptoms and socio-demographic and clinical characteristics of the patients. The perinatal grief symptoms can decrease gradually from termination of pregnancy to six months and can persist for a period of six months up to a year. There was positive correlation between the scores of PGS and BAI, IES-R hyper-arousal. The mean score of PGS changed significantly from sixth week to sixth month and from sixth week to 12th months. IES-R hyper-arousal and MRQ relational satisfaction were found to be the predictors for PGS total score at the first year. Conclusion: The diagnosis of fetal anomaly and especially the termination of pregnancy itself may be traumatic and disruptive. In women with perinatal loss, grief may become persistent after the first six months. It would be helpful to examine how the women resolve this experience. Especially the anxiety and the hyper-arousal signs following the termination should not be ignored. Perinatal grief is a unique bereavement experience; specific interventions should be performed for detecting and treating severe perinatal grief.

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“…In the studies conducted in the same center, Çorbac›o¤lu et al [16] found CNS anomaly as the most common anomaly (52%) in 498 termination cases and reported the incidence of the multiple system anomaly 10% while Aslan et al [17] found CNS as the most common anomaly with a rate of 58% and reported the incidence of the multiple system anomaly 8.4%. Moreover, Tayyar et al [18] also found CNS anomaly as the most common anomaly with a rate of 45% in the cases which underwent late termination, and they reported multiple system anomaly 8% in their study, which was conducted in the same center as well. In our study, isolated anomalies were 73.3% of the structural anomalies while multiple system anomalies were 26.7% of them.…”

Section: Discussionmentioning

confidence: 88%

“…In consistence with the literature, we may associate it with the fact that the ultrasonographic diagnosis of the cardiac anomalies is established in later weeks. [19] While Vaknin et al [14] reported the rates of chromosomal diseases in the cases which underwent termination 35% for the early terminations and 26% for the late terminations, Tayyar et al [18] reported it 19% for the late the late terminations. Çorbac›o¤lu et al [16] compared the rates of chromosomal diseases in cases which underwent termination between 2002-2006 and 2007-2010, they found that the rates were significantly higher between 2007 and 2010 and associated it with the prevalent use of aneuploidy screening tests.…”

Section: Discussionmentioning

confidence: 99%

The assessment of early and late gestational termination cases

Kaya¹,

Vaizoğlu²,

Uzuner³

et al. 2020

Perinatal J

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Objective We aimed to investigate the characteristics of early and late gestational termination cases by evaluating the cases underwent gestational termination in our clinic. Methods All pregnant women who had singleton pregnancy and underwent gestational termination due to fetal indications between January 2017 and December 2019 were included in the study. Results A total of 341 cases, of which 263 were with early gestational termination (Group 1) and 73 were with late gestational termination (Group 2) were included in the study. No difference was observed between the demographic characteristics of the groups. The ultrasonographic structural anomaly was observed in 273 (80.1%) of 341 cases and no structural anomaly was observed in 68 (19.9%) cases. Of the cases with structural anomaly, 200 (73%) had isolated system anomaly and 73 (26.7%) had multiple system anomaly. Karyotype analysis was performed in 68% of the cases, and chromosomal anomaly was found in 52.6% of them. Among the cases with normal karyotype analysis results, 22 cases had single gene disorder, of which mostly had thalassemia. While the incidence of structural anomaly was significantly high in the late termination cases (91% vs. 76.8%), the incidence of isolated cardiovascular anomaly was significantly high in the late termination cases similarly (37.5% vs. 13.8%). The autopsy was performed on 16.7% of the cases after termination and the findings were consistent with the prenatal ultrasonographic results in 86% of the cases, and additional findings were found in 22.4% of the cases in the autopsy. Conclusion When the late gestational terminations performed in our clinic are compared to the early gestational terminations, we believe that conducting ultrasonographic anomaly screening to all pregnant women including echocardiography even at a less rate, and also making screening programs in the early gestational periods such as aneuploidy screening easily accessible for all pregnant women may help to maintain maternal health by decreasing the rates of the cases with late gestational

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Late termination of pregnancy due to fetal abnormalities: An analysis of 229 cases

Abstract: ÖZ Amaç: Fetal anomali nedeniyle geç terminasyon uygulanan gebeliklerde endikasyonları incelemek. Gereç ve

Cited by 4 publications

References 14 publications

The analysis of the termination of pregnancies at and after ten weeks of gestation – a monocenter study

The analysis of the termination of pregnancies at and after ten weeks of gestation – a monocenter study

Perinatal Grief and Related Factors After Termination of Pregnancy for Fetal Anomaly: One-Year Follow-up Study

The assessment of early and late gestational termination cases

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