VP02.12: Pregnancy termination for fetal abnormality: a one‐year study

The purpose of this study is to evaluate the major indications for pregnancy termination (PT) in a tertiary referral centre, the obstetrics characteristics and PT procedures. A descriptive retrospective study including all cases of PT due to some type of fetal abnormality between January 2019 and December 2019 was conducted. Parameters registered were: maternal age, parity, gestational age, poor obstetric history, familiar history, categorical and specific diagnoses of fetal abnormalities, final committee decision and need for a surgical approach. In 2019, a total of 52 fetal abnormality cases were discussed by the hospital committee. The majority (94%) were spontaneous pregnancies. 30.8% had prior poor obstetric outcome. The mean maternal age was 34,06 years (17–44 years). The mean parity was 0.65. The mean gestational age at committee discussion was 19 weeks (9–34 weeks). The mean time interval between the couple request and the committee decision was 1.5 days (0–6 days) and between the committee decision and the pregnancy termination was 2.7 days. The majority of fetal abnormalities were diagnosed in the first trimester (50%). Genetic disorders were the most commonly observed fetal abnormality occurring in 21 (40.4%) cases, being the Trisomy 21 (47.6%) and 18 (28.6%) the most frequent. The other main fetal abnormality groups included central nervous system (CNS) abnormalities (n = 14, 26.9%) and cardiovascular system (CVS) abnormalities (n = 6, 11.5%). The success rate of medical PT with mifepristone and misoprostol was 76.9%, with 19.2% of cases requiring further intervention with suction dilation and curettage for retained tissue. Pregnancy termination for fetal abnormality is currently one of the few clinical practices which management is based on a scientific, ethical, legal and case by case decision. In our centre, the genetic disorders are the most frequent indication for pregnancy termination followed by fetal CNS abnormalities. A medical approach continues to be the preferred route, due to its high success rate.