TERMINATION OF PREGNANCY FOR FETAL ANOMALIES – ANALYSIS OF CASES OVER A 4-YEAR PERIOD

Abstract

Background: The consequence of prenatal detection of fetuses with congenital anomalies is induced ter- mination of pregnancy (TOP). The analysis of the indications for TOP and the agreements between prenatal and pathohistological findings is required to assess the quality of work and the appropriateness of diagnostic procedures. Methods: This retrospective analysis involved the indications for TOP performed for congenital fetal anomalies between January 2005 and March 2009. The TOP cases were divided into two groups: the early (up to 22 week, abortion) and the late (≥ 22 weeks 0/7, delivery) termina- tion group. With regard to the agreement between prenatal and pathohistological postmor- tem findings, 3 groups were created: complete agreement, agreement with additional data provided by pathohistological analysis, disagreement of findings. Results: Of the 220 cases of TOP for congenital anomalies, 180 (82 %) were abortion cases and 40 (18 %) were labour cases. In both groups, the most frequent causes for TOP were fetal structural abnormalities that were not due to chromosomal anomalies (102 (57 %) in the abortion group and 38 (95 %) in the delivery group). The percentage of chromosomal/monogenic anomalies was statistically significantly higher in the abortion (43 %) than in the labour group (only 5 %) (p < 0.001). Pathohistological examination was performed in 172 cases. In 126 (73 %) cases the agreement between prenatal ultrasound and pathohistological find- ings was complete and in 37 (22 %) pathohistological findings provided additional data on congenital anomalies that did not change the prenatally made diagnosis and would not affect the management of pregnancy. In none of the cases did pathohistological findings reject the prenatally made diagnosis. Conclusions: Fetal structural anomalies are frequent cause of TOP. Pathohistological examination of the fetus confirmed the prenatal diagnosis in all the cases, whereas in one fourth of the cases it provided additional information on congenital anomalies.

Keywords

• razvojne nepravilnosti ploda
• umetna prekinitev nosečnosti
• fetalni patohistološki pre- gled