Could some fetocides be avoided by more prompt referral after diagnosis of fetal abnormality?
When a fetal abnormality has been diagnosed, a woman may be offered termination of pregnancy. It is important that delays in the assessment process are avoided, as after 21 weeks' gestation fetocide must be performed as part of the termination, with only a few rare exceptions. To determine whether preventable delays in the assessment of suspected fetal abnormalities are occurring, a retrospective review of all stillbirths resulting from termination of pregnancy in 1998 and 1999 in the North Western Region of England was conducted. There were 47 terminations of pregnancy after 24 weeks gestation. Of these, 43 cases had intracardiac potassium chloride fetocide before induction of labour. One of the 47 women was not referred to the tertiary referral centre; 39 women were referred within 1 week of the diagnosis of an abnormality, but in seven cases referral was delayed for more than 2 weeks. Inappropriate and preventable delays are occurring. In some cases this may mean that a woman has to undergo fetocide, which could have been avoided had she been referred to a tertiary centre more promptly.
Vause
Sarah
S
Department of Obstetrics and Gynaecology, St Mary's Hospital, Hathersage Road, Manchester M13 0JH, UK. svause@central.cmht.nwest.nhs.uk
Sands
J
J
Johnston
T A
TA
Russell
S
S
Rimmer
S
S
D000015:Abnormalities, Multiple / Q000175:diagnosis; D000025:Abortion, Eugenic; D005260:Female; D005313:Fetal Death / Q000139:chemically induced; D005333:Fetus / Q000002:abnormalities*; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D012017:Referral and Consultation; D012189:Retrospective Studies