Retrospective Analysis of Pregnancy Terminations: 9-Years Experience at a Tertiary Hospital in Southeastern Turkey

Abstract

Objective: To determine the indications for termination of pregnancy, and their consistency with autopsy data to offer an insight into termination of pregnancy having regard to conditions in Turkey.

Study Design: Three hundred and ninety-one pregnancies terminated before the 24th gestational week were enrolled in this study. Maternal age, gravidity, parity, abortion, the status of folic acid usage, consanguineous marital status, gestational week, anomalies that led to termination and pathological diagnoses were recorded. Anomalies that led to termination were grouped as central nervous system , cardiovascular system, gastrointestinal system, genitourinary system, pulmonary, musculoskeletal, head-neck, chromosomal, genetic, multiple anomalies and others. Four groups were formed based on the consistency of prenatal ultrasound diagnosis with pathological diagnosis.

Results: Mean age, gravidity, parity, abortion, and gestational week were 28 years, 3, 1, 1, and 15.7 weeks, respectively. One hundred and thirty-eight (35.2%) patients had consanguineous marriage. Three major causes of termination were central nervous system (45.78%), head-neck (17.4%) and multiple anomalies (14%). One hundred and twenty-eight (71.5%) patients with central nervous system anomalies were not using folic acid. Comparison of prenatal ultrasound findings with pathology results, 275 (70.3%) patients had full consistency, 46 (11.8%) had other findings at autopsy besides the confirmed sonographic findings, 34 (8.7%) had some sonographic findings not confirmed at autopsy, and 4 (1%) had no consistency between the findings.

Conclusion: Central nervous system anomalies constitute the most common indication for termination of pregnancy in this retrospective study. Low rate of periconceptional folic acid among those cases is remarkable. First-trimester screening for earlier detection of fetal anomalies may be important in high-risk groups such as those with consanguineous marriages.