Maternal outcomes in first and second trimester termination of pregnancy: which are the risk factors?
- PMID: 29055174
- DOI: 10.1515/jpm-2017-0106
Maternal outcomes in first and second trimester termination of pregnancy: which are the risk factors?
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.
Similar articles
-
Prenatal screening for fetal aneuploidy in singleton pregnancies.J Obstet Gynaecol Can. 2011 Jul;33(7):736-750. doi: 10.1016/S1701-2163(16)34961-1. J Obstet Gynaecol Can. 2011. PMID: 21749752
-
Prenatal screening for and diagnosis of aneuploidy in twin pregnancies.J Obstet Gynaecol Can. 2011 Jul;33(7):754-67. J Obstet Gynaecol Can. 2011. PMID: 21749753
-
Procedure-related risk of miscarriage following chorionic villus sampling and amniocentesis.Ultrasound Obstet Gynecol. 2019 Oct;54(4):452-457. doi: 10.1002/uog.20293. Epub 2019 Sep 6. Ultrasound Obstet Gynecol. 2019. PMID: 30977213
-
Obstetrical complications associated with abnormal maternal serum markers analytes.J Obstet Gynaecol Can. 2008 Oct;30(10):918-932. doi: 10.1016/S1701-2163(16)32973-5. J Obstet Gynaecol Can. 2008. PMID: 19038077 Review. English, French.
-
Pregnancy termination: techniques, risks, and complications and their management.Fertil Steril. 1986 Jan;45(1):5-17. doi: 10.1016/s0015-0282(16)49089-8. Fertil Steril. 1986. PMID: 3510916 Review.
Cited by
-
Clinical and genetic aspects of termination of pregnancy; tertiary center experience.Turk J Obstet Gynecol. 2023 Sep 4;20(3):234-241. doi: 10.4274/tjod.galenos.2023.19677. Turk J Obstet Gynecol. 2023. PMID: 37668046 Free PMC article.
-
[Guideline project termination of pregnancy in the first trimester].Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2025 Jan;68(1):62-68. doi: 10.1007/s00103-024-03988-1. Epub 2024 Dec 4. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2025. PMID: 39630245 German.
-
Postmortem Evaluation of First Trimester Fetal Heart.Curr Health Sci J. 2022 Jul-Sep;48(3):247-254. doi: 10.12865/CHSJ.48.03.01. Epub 2022 Sep 30. Curr Health Sci J. 2022. PMID: 36815087 Free PMC article.
-
Relationship between Serum Gamma-Glutamyltransferase and Glutathione Antioxidant System in Patients with Liver Cirrhosis of Various Etiology.Curr Health Sci J. 2022 Oct-Dec;48(4):436-445. doi: 10.12865/CHSJ.48.04.11. Epub 2022 Dec 31. Curr Health Sci J. 2022. PMID: 37304797 Free PMC article.
-
Prevalence of, and Factors Associated with Hemodynamic Instability Among Women Presenting with Incomplete Abortion at a Tertiary Hospital in Southwestern Uganda.Int J Womens Health. 2025 May 30;17:1547-1556. doi: 10.2147/IJWH.S515760. eCollection 2025. Int J Womens Health. 2025. PMID: 40463624 Free PMC article.
References
-
- Legge 22 maggio 1978, n. 194 – Norme per la tutela sociale della maternità e sull‘interruzione volontaria della gravidanza. http://www.salute.gov.it/imgs/c_17_normativa_845_allegato.pdf.
-
- Kulier R, Gülmezoglu M, Hofmeyr GJ, Cheng LN, Campana A. Medical methods for first trimester abortion. Cochrane Database Syst Rev. 2004:CD002855. Review. Update in: Cochrane Database Syst Rev. 2004:CD002855.
-
- Lohr PA, Hayes JL, Gemzell-Danielsson K. Surgical versus medical methods for second trimester induced abortion. Cochrane Database Syst Rev. 2008:CD 006714.
-
- Esteve JL, Gallego FG, Llorente MP, Bermúdez SB, Sala ES, González LV, et al. Late second-trimester abortions induced with mifepristone, misoprostolo and oxytocin: a report of 428 consecutive cases. Contraception. 2008;78:52–60.
-
- Tristan SB, Gilliam M. First trimester surgical abortion. Clin Obstet Gynecol. 2009;52:151–9.
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical