title: Indications and pregnancy outcomes when multidisciplinary centers for prenatal diagnosis refuse request for termination of pregnancy: a retrospective French study.
abstract: OBJECTIVE
  To report indications and risk factors for effective termination of pregnancy (TOP) when multidisciplinary prenatal diagnosis centers refuse request for TOP.
  
  
  METHODS
  This is a retrospective study from a French national registry between 2005 and 2009. Indication groups for TOP refusal were created. Risk factors for pregnancy outcomes and effective TOP were determined by multinomial logistic regression model.
  
  
  RESULTS
  The overall number of TOP refusals was 573. Indications were single malformations (37%), chromosomal abnormalities (16.6%), hygroma (5.2%), potential fetopathies (11%), maternal indications (17.4%), and other indications (12.7%). Pregnancy outcomes were live infants (35.1%), effective TOP (36.3%), intra-uterine fetal death (5.4%), and lost to follow-up (23.2%). Logistic regression model showed an increased likelihood of effective TOP in groups with single malformations [odds ratio (OR) 3.4, 95% confidence interval (CI) 1.6-7.4], chromosomal abnormalities (OR 3, 95% CI 1.2-7.2), and hygromas (OR 19.6, 95% CI 2.3-16.8) compared with other groups. An increased likelihood of effective TOP was also reported when the request was made at first (OR 29.5, 95% CI 10-16.7) and second (OR 6.3, 95% CI 2.3-16.7) trimesters compared with the third trimester.
  
  
  CONCLUSIONS
  Effective TOP is particularly frequent when requested during the first trimester and in cases of structural anomalies of the fetus.
authors.affiliation: Department of Obstetrics and Gynecology, Caen University Hospital, Caen, France.
authors.forename: M L
authors.initials: ML
authors.lastname: Nguyen
authors.forename: H
authors.initials: H
authors.lastname: Roman
authors.forename: M
authors.initials: M
authors.lastname: Dommergues
authors.forename: E
authors.initials: E
authors.lastname: Verspyck
mesh_terms: D000028:Abortion, Induced; D034462:Dissent and Disputes; D005260:Female; D005602:France / Q000453:epidemiology; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008430:Maternal-Child Health Centers / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011295:Prenatal Care / Q000706:statistics & numerical data; D011296:Prenatal Diagnosis; D016079:Refusal to Treat; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies