Trends in fetal indications for termination of pregnancy between 2002 and 2010 at a tertiary referral centre
- PMID: 24592014
- PMCID: PMC3939143
- DOI: 10.5152/jtgga.2012.09
Trends in fetal indications for termination of pregnancy between 2002 and 2010 at a tertiary referral centre
Abstract
Objective: We reviewed the data of the termination of pregnancy (TOP) cases between 2002 and 2010 to evaluate the changes in fetal indications for both early and late TOPs in this period.
Material and methods: The data of 962 TOP cases were analysed in two groups according to the periods as in 2002-2006 and 2007-2010. The women were also subdivided into two categories according to their gestational age; <23 weeks' gestation (early termination) and ≥23 weeks' gestation (late termination).
Results: Four hundred and fifty-eight (47.6%) of TOPs were performed between 2002 and 2006 (Group 1) and 504 (52.3%) were performed between 2007 and 2010 (Group 2). The number of early (<23 weeks) and late (≥23 weeks) terminations were 583 (60.6%) and 379 (39.3%), respectively. The vast majority of anomalies were central nervous sytem malformations (51.8%). They were followed by multiple anomalies (10.2%) and chromosomal anomalies (9.4%). Chromosomal and cardiovascular system anomalies were significantly higher in 2007-2010 in comparison to 2002-2006 (p<0.0001 and p=0.002, respectively). There was no statistically significant difference between the fetal indications that led to early termination compared to those that led to late termination.
Conclusion: The distribution of indications for TOP was influenced by the development in prenatal screening policy, resulting in a significant increase in terminations due to chromosomal and cardiovascular system anomalies. Cultural, educational, religious and legal factors cause differences in the indications for TOP as well as the gestational age that TOPS are performed.
Amaç: 2002–2010 yılları arasında gerçekleşmiş olan gebelik terminasyonlarına ait verilerin geriye dönük incelenmesi ile bu dönemdeki erken ve geç terminasyonların fetal endikasyonlarında görülen değişimi değerlendirmek.
Gereç ve yöntemler: Dokuzyüz altmış iki terminasyon olgusuna ait veriler 2002–2006 ve 2007–2010 olmak üzere iki ayrı dönemde incelendi. Olgular ayrıca gebelik haftalarına göre iki alt gruba ayrıldı; <23 hafta (erken terminasyon) ve ≥23 hafta (geç terminasyon).
Bulgular: Terminasyonların 458’i (%47.6) 2002 ve 2006 yılları arasında (Grup 1) ve 504’ü (%52.3) 2007 ve 2010 yılları arasında (Grup 2) yapıldı. Erken (<23 hafta) ve geç (≥23 hafta) terminasyonların sayısı sırasıyla 585 (%60.6) ve 379 (%39.3) idi. Anomalilerin büyük çoğunluğunu santral sinir sistemi malformasyonları oluşturuyordu (%51.8). Bunu çoklu anomaliler (%10.2) ve kromozom anomalileri (%9.4) izliyordu. Kromozom ve kardiyovaskuler sistem anomalileri 2007–2010 yıllarında 2002–2006 yıllarına kıyasla anlamlı şekilde artış gösterdi (sırasıyla p<0.0001 and p=0.002). Erken terminasyon ve geç terminasyona neden olan fetal endikasyonlar arasında istatistiksel olarak anlamlı bir fark saptanmadı.
Sonuç: Terminasyon endikasyonlarının dağılımı prenatal tarama politikalarındaki gelişimden etkilenmiş, buna bağlı olarak kromozom ve kardiyovaskuler sistem anomalileri nedeniyle yapılan terminasyonların sayısı önemli ölçüde artmıştır. Kültürel, eğitimsel, dini ve yasal faktörler terminasyon yapıldığı gebelik haftasının yanı sıra terminasyon endikasyonlarında da değişikliklere yol açmaktadır.
Keywords: Termination of pregnancy; chromosomal anomaly; fetal anomaly; prenatal screening; ultrasound.
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