Eyisoy Ömer Gökhan, Özgökçe Çağdaş, Uygur Lütfiye, Eriç Özdemir Mucize, Taşdemir Ümit, Öcal Aydın, Demirci Oya
University of Health Sciences Turkey, Zeynep Kamil Women and Children Diseases Training and Research Hospital, Clinic of Perinatology, İstanbul, Turkey.
University of Health Sciences Turkey, İstanbul Haseki Training and Reseasch Hospital, Clinic of Obstetrics, Division of Perinatology, İstanbul, Turkey.
Turk J Obstet Gynecol. 2023 Sep 4;20(3):234-241. doi: 10.4274/tjod.galenos.2023.19677.
The aim of the study was to retrospectively analyze the indications Techniques and complications of pregnancy termination performed in a tertiary center.
All cases between 10 and 33 weeks of gestation between January 2021 and June 2023 were retrospectively analyzed. The patients were divided into two groups as group 1 with 11+0 to 21+6 gestational weeks and group 2 for those at 22+0 and 33+0 gestational weeks.
A total of 568 pregnancy terminations were included in the study. Among all terminations the most common fetal indications were central nervous system anomalies (148 cases, 26%) and trisomy 21 (53 cases, 9%) and the most common maternal/obstetrical Indication was previable premature rupture of the membranes (179 cases, 31.5%). Abnormal genetic results were found in 50 of 173 cases (28.9%) with a termination indication of Structural malformation who accepted invaziv genetic testing. The number of terminations with fetal indications performed after 22 weeks were 148 (41%) and 11 (7.4%) cases of these late terminations of pregnancy were anomalies expected to be diagnosed in the first trimester. Complication rates (12.4%) and abdominal termination rates (3.5%) were significantly higher in group 2 than in group 1 (p<0.05).
Improvements in prenatal genetic screening and diagnostic techniques will undoubtedly decrease the gestational ages in terminations of pregnancies. However, there will always be cases that can neither be diagnosed earlier nor can be treated due to the nature of the anomaly. In the management of such cases, terminations will always occupy an important place in prenatal care.
本研究旨在回顾性分析在一家三级医疗中心进行的终止妊娠的指征、技术及并发症。
回顾性分析2021年1月至2023年6月期间妊娠10至33周的所有病例。患者分为两组,第1组为妊娠11+0至21+6周,第2组为妊娠22+0至33+0周。
本研究共纳入568例终止妊娠病例。在所有终止妊娠病例中,最常见的胎儿指征是中枢神经系统异常(148例,26%)和21三体综合征(53例,9%),最常见的母体/产科指征是胎膜早破(179例,31.5%)。在173例因结构畸形而接受侵入性基因检测的终止妊娠指征病例中,50例(28.9%)发现基因异常。22周后因胎儿指征进行的终止妊娠例数为148例(41%),其中11例(7.4%)晚期终止妊娠的异常情况预计在孕早期即可诊断。第2组的并发症发生率(12.4%)和经腹终止妊娠率(3.5%)显著高于第1组(p<0.05)。
产前基因筛查和诊断技术的改进无疑将降低终止妊娠的孕周。然而,由于异常情况的性质,总会有一些病例既无法早期诊断,也无法治疗。在这类病例的管理中,终止妊娠在产前护理中始终占有重要地位。