The impact of prenatal ultrasound screening on termination of pregnancy with and without feticide: a retrospective analysis.

BACKGROUND

Provision and uptake of antenatal screening is nonuniform in Austria, as there is no national screening program. The aim of the study was to evaluate the influence of prenatal ultrasound screening methods on the time of diagnosis and therefore the rate of feticide in pregnancies with fetal malformations.

METHOD

Retrospective data analysis of terminations of pregnancies (TOP) with and without feticide due to fetal structural anomalies at a single tertiary care referral center in Austria between 2007 and 2020.

RESULTS

Over the study period, the number of TOPs increased overall, and a nonsignificant rise in the rate of feticide was observed. Women who underwent TOP without feticide significantly more often had first trimester screening; in particular, 588 (86%) cases compared to 121 (57%) with feticide (p < 0.001). Furthermore, in the subgroup of cases diagnosed after 20 weeks of pregnancy (WoP), a significant association between cases without a mid-trimester anomaly scan and TOP with feticide was found. Gestational age at diagnosis was influenced by the type of malformation and therefore the affected organ system.

CONCLUSION

First trimester screening is critical in early fetal assessment and preventing unnecessary late terminations and feticide. Mid-trimester anomaly scan further increases the early detection of fetal malformations, especially those that become apparent later in pregnancy. Consequently, comprehensive counselling regarding the benefits of prenatal ultrasound screening should be provided to all pregnant women.