Indications and pregnancy outcomes when multidisciplinary centers for prenatal diagnosis refuse request for termination of pregnancy: a retrospective French study. (20th March 2013)

• Record Type: Journal Article
• Authors: Nguyen, M. L.; Roman, H.; Dommergues, M.; Verspyck, E.
• Is Part Of: Prenatal diagnosis. Volume 33:Number 5(2013:May)
• Page Start: 442
• Page End: 448
• Publication Date: 2013-03-20
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.4085
• Languages: English
• ISSNs: 0197-3851

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="pd4085-sec-0001" sec-type="section"> <title>Objectives</title> <p>To report indications and risk factors for effective termination of pregnancy (TOP) when multidisciplinary prenatal diagnosis centers refuse request for TOP.</p> </sec> <sec id="pd4085-sec-0002" sec-type="section"> <title>Methods</title> <p>This is a retrospective study from a French national registry between 2005 and 2009. Indication groups for TOP refusal were created. Risk factors for pregnancy outcomes and effective TOP were determined by multinomial logistic regression model.</p> </sec> <sec id="pd4085-sec-0003" sec-type="section"> <title>Results</title> <p>The overall number of TOP refusals was 573. Indications were single malformations (37%), chromosomal abnormalities (16.6%), hygroma (5.2%), potential fetopathies (11%), maternal indications (17.4%), and other indications (12.7%). Pregnancy outcomes were live infants (35.1%), effective TOP (36.3%), intra‐uterine fetal death (5.4%), and lost to follow‐up (23.2%). Logistic regression model showed an increased likelihood of effective TOP in groups with single malformations [odds ratio (OR) 3.4, 95% confidence interval (CI) 1.6–7.4], chromosomal abnormalities (OR 3, 95% CI 1.2–7.2), and hygromas (OR 19.6, 95% CI 2.3–16.8) compared with other groups. An increased likelihood of effective TOP was also reported when the request was made at first (OR 29.5, 95% CI 10–16.7) and second (OR 6.3, 95% CI 2.3–16.7) trimesters compared with the third trimester.</p> </sec> <sec id="pd4085-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Effective TOP is particularly frequent when requested during the first trimester and in cases of structural anomalies of the fetus. © 2013 John Wiley & Sons, Ltd.</p> </sec> </abstract>