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. 2018 May 24;46(4):373-378.
doi: 10.1515/jpm-2017-0106.

Maternal outcomes in first and second trimester termination of pregnancy: which are the risk factors?

Giulia Garofalo  1 , Anna Garofalo  1 , Olga Sochirca  1 , Maria Grazia Alemanno  1 , Eleonora Pilloni  1 , Marilisa Biolcati  1 , Elisabetta Muccinelli  1 , Elsa Viora  1 , Tullia Todros  1
Affiliations

Maternal outcomes in first and second trimester termination of pregnancy: which are the risk factors?

Giulia Garofalo et al. J Perinat Med. .

Abstract

Aims: To evaluate maternal complications of first trimester and second trimester termination of pregnancy (TOP) performed after first or second trimester positive prenatal diagnosis (PD).

Results: We performed a retrospective study from January 2007 to December 2011, on 844 patients, who underwent a TOP after positive amniocentesis or chorionic villus sampling (CVS) for foetal aneuploidies, performed for maternal age ≥35 years of age, positive prenatal screening (PS) or for genetic reasons. Exclusions criteria were gestational age >22+0 weeks, twin pregnancy and co-existing maternal pathologies. We compared maternal complications of first trimester and second trimester TOP and we established which risk factors were correlated to higher maternal complications (haemorrhages, transfusion, repeated uterine curettage and infections). Maternal complications were significantly higher in second trimester TOP. Previous uterine surgery is a significant risk factor for maternal complications in second trimester TOP, but not in first trimester TOP. Six uterine ruptures and three hysterectomies occurred, all in multiparous women with second trimester TOP. All uterine ruptures occurred in women with previous caesarean sections.

Conclusions: First trimester TOP in women with risks factors for maternal complications guarantees better maternal outcomes and less health costs. Thus, in these women we should prefer a first trimester PS and PD.

Keywords: Caesarean section; invasive prenatal diagnosis; maternal complications; prenatal screening; termination of pregnancy.

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