Late selective termination of fetal abnormalities in twin pregnancies: a multicentre report.
OBJECTIVE
To evaluate the outcome of late selective fetal termination based on combined data from eight tertiary perinatal centres.


METHODS
Israeli law requires institutional committee approval for pregnancy termination. Moreover, after 24 weeks only a district superior committee can approve the termination. A total of 36 bichorionic twin pregnancies who underwent selective fetal termination after 24 complete gestational weeks were identified in eight Israeli centres.


RESULTS
In 23 women (63.9%) the indication for selective termination was structural anomaly, and in 13 (36.1%) the indication was chromosomal abnormality. The mean gestational age at the time of diagnosis was 24.1 +/- 1.9 weeks. The termination procedure was performed at a mean gestational age of 25.5 +/- 2.0 weeks (median 25, range 24-33 weeks). There was one case of immediate procedure-related complication (i.e. amnionitis) and the unaffected infant died, which was the only perinatal death in this series. No evidence of coagulopathy was reported. Only five women (13.8%) delivered before 34 completed weeks. The mean gestational age at delivery was 36.9 +/- 2.9 weeks (28-41 weeks), and the mean procedure-to-delivery interval was 11.8 +/- 3.2 weeks (median 13, range 3-17 weeks).


CONCLUSIONS
Late (> 24 weeks) selective termination in twin pregnancies is associated with favourable perinatal outcome of the healthy twin. In countries where the law permits late pregnancy termination, the parents should be informed of that possibility.
Lipitz
S
S
Department of Obstetrics and Gynaecology, Chaim Sheba Medical Center, Tel Hashomer & Sackler School of Medicine, Tel Aviv University, Israel.
Shalev
E
E
Meizner
I
I
Yagel
S
S
Weinraub
Z
Z
Jaffa
A
A
Shalev
J
J
Achiron
R
R
Schiff
E
E
D000328:Adult; D001724:Birth Weight; D000013:Congenital Abnormalities / Q000628:therapy*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007557:Israel; D008423:Maternal Age; D011247:Pregnancy; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal; D012189:Retrospective Studies; D014427:Twins