[Fetal abnormalities leading to termination of pregnancy: the experience at the Assaf Harofeh Medical Center between the years 1999-2000]

Abstract

Objectives: To assess the distribution of fetal indications leading to termination of pregnancy.

Design: A retrospective study.

Methods: The study included all parturient women with singleton pregnancy, who underwent termination of pregnancy due to fetal abnormalities (structural, chromosomal/genetic, infections). The women were subdivided into two groups according to their gestational age, i.e. early termination (gestational period < 23 weeks) and late termination (gestational period > 23 weeks).

Results: A total of 137 terminations of pregnancies were performed, including 102 early terminations and the rest--late terminations. The mean maternal age was 31 +/- 5 years. The termination procedures were performed at a mean gestational age of 20 +/- 5 weeks. The main indications in the early-termination subgroup were structural and chromosomal/genetic (n = 45, 44% for each subgroup). Multiple abnormalities were more common in the early-termination group (18% versus 7%). In the late-termination subgroup the leading indications were structural anomalies (n = 29, 83%) that were subdivided into neurological defects (31%) followed by skeletal deformities (23%). In addition, in the late-termination subgroup there were more cardiac and urinary tract defects (17% versus 11% and 14% versus 9%, respectively). Among the chromosomal aneuploidies, trisomy 21 was diagnosed in 24 cases (53%). Fetal infections were diagnosed in 13 pregnancies (9%), with only one of these detected in advanced gestation. The leading infectious agent was cytomegalovirus.

Conclusions: In the early-termination subgroup the main indications were equally divided between structural and chromosomal/genetic defects while in the late-termination subgroup the leading cause was structural defects.