The reasons for termination of pregnancy in the third trimester

Abstract

ObjectiveDesign Retrospective study. SettingPopulation A consecutive series of 956 terminations of pregnancy performed for fetal anomalies in singleton pregnancies, 305 of which were in the third trimester and 651 in the second. Main outcome measuresIndications for termination of pregnancy; process leading to late termination of pregnancy; maternal morbidity. ResultsOne hundred and thirteen (37%) third trimester terminations of pregnancy were associated with false negative resulted from the results of earlier screening tests. In 15 terminations (5%), the decision was postponed, although the poor fetal prognosis was established earlier. In 55 (1 8%) the diagnosis was not possible earlier than the third trimester, and in 122 (40%) the diagnosis was possible earlier but the poor prognosis for the fetus was not established until the third trimester. Maternal morbidity due to termination of pregnancy was similar in the second and third trimester.Conclusion One-third of late terminations of pregnancy could have been avoided by more efficient screening in the second trimester. However, because fetal prognosis is not always clear when a malformation is diagnosed, postponing the decision until fetal development allows more thorough evaluation and may avoid unnecessary termination of pregnancy in the second trimester. This could be the main beneficial aspect of not setting a limit to the gestational age for performing termination of pregnancy.To analyse the process in making decisions leading to termination of pregnancy in the third trimester and to evaluate the maternal morbidity associated with this procedure.

Termination of pregnancy for fetal anomaly after 23 weeks of gestation: a European register‐based study

“…Several other studies have reported previously a high prevalence of late TOPFA in France. 2,4,5 The variations in TOPFA rates in Europe have been reported previously. 1,5,6 In Paris, the second trimester anomaly scan tends to be performed later than in other European countries.…”

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

“…Erken terminasyonların aksine geç terminasyonların en sık nedeni, fetal yapısal anomaliler olup, bunlar içinde en sık görülen fetal yapısal anomaliler MSS anomalileridir (9,11,14,15,16) . Hidrosefali, korpus kallosum agenezisi ve lizensefali gibi genellikle ikinci ve erken üçüncü trimesterde belirgin hâle gelen MSS anomalilerinin geç terminasyonlardaki sıklığı daha fazladır (11) .…”

“…Türkiye'de yapılan önceki çalışmalarla kıyaslandı-ğında, NTD' ye bağlı geç terminasyon sıklığı azalır-ken, NTD dışı anomalilerin sıklığında artış gözlendi (2,8) . Fakat diğer ülkelerin verileri ile kıyaslandığında NTD nedeniyle uygulanan geç terminasyon oranı yine de belirgin olarak yüksekti (4,9,14) .…”

Late termination of pregnancy by intracardiac potassium chloride injection: 5 years' experience at a tertiary referral centre

“…Several methods of feticide have been described, [6][7][8][9][10][11] including intracardiac or intraumbilical potassium chloride or lignocaine injection to induce cardiac asystole. For women who choose to terminate pregnancy with an abnormal fetus at an advanced gestation, the method used must be safe and effective.…”