Termination of pregnancy due to fetal central nervous system abnormalities performed after 24 weeks’ gestation: survey of 57 fetuses from a single medical center
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To assess fetal central nervous system (CNS) abnormalities presenting as major findings leading to late termination of pregnancy (late TOP) performed ≥ 24 weeks’ gestation.
The study population included 2789 pregnant women that underwent late TOP in our institute between the years 1998 and 2015.
Fifty-seven cases (2.0%) underwent late TOP because of fetal CNS indications and are the subjects of the current study. Those cases were subdivided into four categories (1) no routine prenatal screening with an incidental finding discovered ≥ 24 weeks’ gestation (25 patients, 43.8%); (2) developmental or acquired findings detected during late second and third trimester (22 patients, 38.6%); (3) apparently normal routine screening with abnormal findings that could have been detected earlier (six patients, 10.6%); (4) routine prenatal care raised suspicion of abnormalities, and the final diagnosis was established only following additional tests (four patients, 7.0%).
Combining the two categories of CNS abnormalities, i.e., pregnant women who did not undergo any fetal evaluation (group 1) and those that could have been detected earlier (group 3) consists 54% from our cohort in which late TOP could have been avoided. On contrary, 39% fetuses from our study population had CNS developmental findings which could be detected only at advanced stage of gestation.
KeywordsAnomaly scan Ultrasound Fetal CNS abnormalities Late termination of pregnancy
All authors contributed to this publication. We hereby confirm that each author has fulfilled the conditions of having made substantial contributions to the concept (Maymon R; Vaknin Z) and design (K. Krajden Haratz, I. Goldrat), analysis (I. Ben-Ami) and interpretation of data (M. Shavit) and drafting and/or revisions of the manuscript (Maymon R and Melcer Y).
The authors have no funding to report.
Compliance with ethical standards
Conflict of interest
We declare that all authors have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Boards in April 2016 (number 73/11). The patient’s informed consent for participation in the study was not required.
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