Changing Trends over the Years in Pregnancy Termination due to Fetal Anomalies

Abstract

Introduction:To examine the indications for termination due to fetal anomalies performed in our clinic between January 2015 and October 2020 and to determine the differences between years.Methods:This study is a retrospective, observational study involving 385 patients who underwent termination before the 24th week due to fetal anomalies at Karadeniz Technical University, Farabi Hospital, Clinic of Perinatology. Termination data were analyzed by dividing the sample into two groups: terminations performed between 11 and 14 weeks (first trimester) and those between 15 and 24 weeks (second trimester) of gestation.Results:Structural malformations constituted 81.3% of termination of pregnancy (TOP) cases, chromosomal anomalies 14.5%, and genetic diseases 4.2%. Central nervous system (CNS) anomalies, at 43.4%, were the most common cause of termination. Aneuploidy was present in 56 (34.8%) of 161 cases for which karyotype analysis was available. The number of terminations that took place in both the first and the second trimesters was the highest in 2019. A continuous increase was observed in the number of terminations over the years evaluated. When the systems were evaluated individually, it was observed that the number of cases in the second trimester with CNS and face and neck anomalies was statistically significantly higher than that in the first trimester (p=0.002, p=0.037, respectively). In all, 28.3% of terminations were performed in the first trimester and 71.7% in the second trimester.Conclusion:When the distribution of TOP indications over the years was examined, it was observed that the number of cases related to chromosomal anomalies, cardiovascular system anomalies, and genetic diseases had increased gradually.

Keywords

• aneuploidy
• congenital anomalies
• karyotype
• prenatal diagnosis
• termination of pregnancy