Effect of fetal diagnosis on the outcomes of second-trimester pregnancy termination for fetal abnormalities: a pilot study.
OBJECTIVE
To explore whether the outcomes of second-trimester pregnancy termination for fetal abnormalities are affected by fetal diagnoses.


METHODS
This was a retrospective review of cases undergoing second-trimester pregnancy termination for the fetal diagnoses of hemoglobin Barts, trisomy 21, and trisomy 18 during the period from 1999 to 2006. The affected pregnancies were terminated by vaginal misoprostol. The outcome measures were: (1) abortion within 24 hours after misoprostol commencement, (2) histology-confirmed incomplete abortion, and (3) experience of significant side effects during termination (temperature over 39 degrees C or need for metoclopramide for vomiting).


RESULTS
One hundred and twenty cases were available for analysis. After adjusting for maternal age, parity, history of cesarean delivery, body mass index, gestation, and fetal hydrops, pregnancy termination for trisomy 21 was associated with a higher risk of incomplete abortion than trisomy 18 and hemoglobin Barts (odds ratio 5.25, 95% confidence interval 1.24-22.19, p = 0.024). The chance of abortion within 24 hours and experience of significant side effects were not found to be associated with fetal diagnosis.


CONCLUSIONS
Pregnancy termination for trisomy 21 is associated with a higher risk of incomplete abortion. Fetal diagnosis affects the outcome of pregnancy termination.
Lo
T K
TK
Department of Obstetrics and Gynaecology, Prenatal Diagnosis and Counselling Centre, Hong Kong, SAR, China. a9401438@graduate.hku.hk
Lau
W L
WL
Lai
F K
FK
Lam
H S W
HS
Tse
H Y
HY
Leung
W C
WC
Chin
R K H
RK
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000025:Abortion, Eugenic / Q000379:methods; D000282:Administration, Intravaginal; D000328:Adult; D002887:Chromosomes, Human, Pair 18; D004314:Down Syndrome / Q000175:diagnosis / Q000473:pathology; D005260:Female; D005333:Fetus / Q000002:abnormalities* / Q000473:pathology; D006455:Hemoglobins, Abnormal / Q000378:metabolism; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage; D010865:Pilot Projects; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000502:physiology; D011296:Prenatal Diagnosis / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014314:Trisomy / Q000175:diagnosis; D017085:alpha-Thalassemia / Q000175:diagnosis / Q000473:pathology
D000020:Abortifacient Agents, Nonsteroidal; D006455:Hemoglobins, Abnormal; D016595:Misoprostol; C030448:hemoglobin Bart's