Fetal abnormalities leading to termination of singleton pregnancy: the 7-year experience of a single medical center.
OBJECTIVE
To assess the distribution of fetal indications leading to termination of pregnancy (TOP) in our institute.


METHODS
All pregnant women with singleton pregnancies who underwent TOP due to fetal abnormalities in our institute between January, 1998 and December, 2004 were divided between early TOP (<23 weeks' gestation) and late TOP (> or =23 weeks' gestation).


RESULTS
There were 328 (71%) and 134 (29%) early and late TOPs, respectively. The TOPs were performed at a mean gestational age of 20.1 +/- 4.8 weeks. The groups varied significantly in the indications for TOP (p = 0.04), which were primarily structural abnormalities (mostly CNS) followed by chromosomal/genetic defects. Fetal structural abnormalities were more common in the late TOP group (62.7% vs 54.2%) while chromosomal-genetic defects were more common in the early TOP group (40% vs 29.1%, respectively). Fetal infection (mostly cytomegalovirus) was similar ( approximately 4%) for both groups. The early TOP group had significantly more hydrops, gastrointestinal, face and neck abnormalities, while the late TOP group had significantly more cardiovascular abnormalities (p < 0.01).


CONCLUSIONS
The impact of early chromosomal/genetic screening contributes to early TOPs, while midgestation anomaly and cardiac scanning significantly contribute to late TOPs. Fetal infection contributes equally to both categories of TOPs.
Vaknin
Zvi
Z
Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel.
Ben-Ami
Ido
I
Reish
Orit
O
Herman
Arie
A
Maymon
Ron
R
D000025:Abortion, Eugenic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D002490:Central Nervous System / Q000002:abnormalities; D002869:Chromosome Aberrations; D025063:Chromosome Disorders / Q000175:diagnosis; D000013:Congenital Abnormalities / Q000453:epidemiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies