Effect of fetal diagnosis on the outcomes of second-trimester pregnancy termination for fetal abnormalities: A pilot study

Abstract

Objective. To explore whether the outcomes of second-trimester pregnancy termination for fetal abnormalities are affected by fetal diagnoses.

Methods. This was a retrospective review of cases undergoing second-trimester pregnancy termination for the fetal diagnoses of hemoglobin Barts, trisomy 21, and trisomy 18 during the period from 1999 to 2006. The affected pregnancies were terminated by vaginal misoprostol. The outcome measures were: (1) abortion within 24 hours after misoprostol commencement, (2) histology-confirmed incomplete abortion, and (3) experience of significant side effects during termination (temperature over 39°C or need for metoclopramide for vomiting).

Results. One hundred and twenty cases were available for analysis. After adjusting for maternal age, parity, history of cesarean delivery, body mass index, gestation, and fetal hydrops, pregnancy termination for trisomy 21 was associated with a higher risk of incomplete abortion than trisomy 18 and hemoglobin Barts (odds ratio 5.25, 95% confidence interval 1.24–22.19, p = 0.024). The chance of abortion within 24 hours and experience of significant side effects were not found to be associated with fetal diagnosis.

Conclusions. Pregnancy termination for trisomy 21 is associated with a higher risk of incomplete abortion. Fetal diagnosis affects the outcome of pregnancy termination.

Keywords:

• Second trimester
• termination of pregnancy
• fetal abnormality
• fetal diagnosis
• outcomes