[Voluntary pregnancy termination over the first trimester. A five-year observation].
OBJECTIVE
The law for legalising abortion was approved by the Italian Government in May 1978. In regulating legal abortion this law identifies two different scenarios: one where legal abortion is performed within 90 days of gestational age, and the second where it can be performed beyond this term but within 120 days: ''when pregnancy or delivery can cause a severe damage to the woman's life, in case of severe pathologies, as fetal relevant anomalies or malformations which can cause a severe damage to the woman's physical or psychological health''. Since during the last years an increase of requests for voluntary pregnancy termination (VPT) over 90 days of gestational age has been observed in Italy, it was decided to carry out a retrospective study on the reasons for requesting such an operation.


METHODS
All interventions for VPT over 90 days of gestational age performed in the Department of Obstetrics and Gynecology in the University of Rome ''La Sapienza'' between January 2003 and December 2007 have been re-assessed, analysing age of women, obstetric anamnesis, reasons for VPT request, gestational age, mode of intervention, complications due to intervention and days of inpatient admission.


RESULTS
During five years 255 women demanded to terminate a pregnancy over the first trimester. In all cases requested have been authorized following a psychological consult assessing a severe damage on psychological health by the Clinical Psychology Service of ''La Sapienza'' University, that in all cases was subsequent to a diagnosis of fetal anomalies, ascertained by a genetic test and/or ultrasound scan. Anomalies were genetic in 112 of cases (43.2%) and morphological, both single and multiple, in 143 of cases (56.8%). In most of the cases (65%) these anomalies have been assessed by ultrasound scan, while in 35% by cariotype analysis.


CONCLUSIONS
After the legalisation in 1978, cases of abortion have constantly increased. More detailed data would be helpful to better understand and face this event.
Dipartimento di Ginecologia e Ostetricia, Università degli Studi di Roma ''La Sapienza'', Roma, Italia. carlo.bastianelli@uniroma1.it.
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Bastianelli
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Filippi
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Farris
D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology; D005333:Fetus / Q000002:abnormalities; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies
Interruzione volontaria di gravidanza oltre il primo trimestre. Cinque anni di osservazione.