title: The effect of a policy change on late termination of pregnancy in Israel.
abstract: OBJECTIVE
  To compare approval rates of late termination of pregnancy (LTOP) requests before and after a policy change in Israel in late 2007.
  
  
  METHODS
  In a retrospective study, LTOP requests and board decisions from 2002-2007 (group 1) were compared with those from 2007-2012 (group 2) at 3 university-affiliated medical centers in Israel. Reasons for application, approval, or rejection were compared between the groups.
  
  
  RESULTS
  There were 552 applications for LTOP. The overall approval rate for LTOP and the specific approval rate per medical indication did not differ significantly between the groups. The rate of requests due to confirmed genetic anomalies decreased from 18.4% in group 1 to 11.3% in group 2 (P=0.03). Compared with group 1, the rate of rejection for intrauterine infection increased from 8.3% to 26.3% (P=0.2), and that for pregnancy complications decreased from 62.5% to 35.0% (P=0.2) in group 2 but these differences were not statistically significant. Requests due to structural anomalies were declined because they were considered to be minor cardiac, renal, cerebral, or skeletal anomalies.
  
  
  CONCLUSIONS
  The more stringent 2007 criteria for approving requests for LTOP did not affect the rate of rejection of requests due to structural anomalies between the 2 time periods.
authors: Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.
authors: Amir
authors: A
authors: Aviram
authors: Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors: Ami
authors: A
authors: Fishman
authors: Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel.
authors: Maya
authors: M
authors: Steinberg
authors: Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel; Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors: Ido
authors: I
authors: Solt
authors: Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel. Electronic address: rami.aviram@clalit.org.il.
authors: Rami
authors: R
authors: Aviram
mesh_terms: D000025:Abortion, Eugenic / Q000639:trends*; D000013:Congenital Abnormalities / Q000175:diagnosis; D003586:Cytomegalovirus Infections / Q000175:diagnosis; D005260:Female; D030342:Genetic Diseases, Inborn / Q000175:diagnosis; D005865:Gestational Age; D006291:Health Policy; D006801:Humans; D007557:Israel; D018579:Patient Selection; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011296:Prenatal Diagnosis; D012189:Retrospective Studies
keywords: Fetal anomalies; Prenatal diagnosis; Termination of pregnancy