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Termination of pregnancy due to fetal central nervous system abnormalities performed after 24 weeks’ gestation: survey of 57 fetuses from a single medical center

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To assess fetal central nervous system (CNS) abnormalities presenting as major findings leading to late termination of pregnancy (late TOP) performed ≥ 24 weeks’ gestation.

Method

The study population included 2789 pregnant women that underwent late TOP in our institute between the years 1998 and 2015.

Results

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%).

Conclusions

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.

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Funding

The authors have no funding to report.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, 70300, Israel

    Yaakov Melcer, R. Maymon, I. Goldrat, I. Ben-Ami & Z. Vaknin

  2. Department of Obstetrics and Gynecology, Ultrasound in Ob/Gyn Unit and Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel

    K. Krajden Haratz

  3. Department of Obstetrics and Gynecology, Meir Medical Center, Kfar-Saba, Israel

    M. Shavit

  4. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Yaakov Melcer, R. Maymon, K. Krajden Haratz, I. Goldrat, M. Shavit, I. Ben-Ami & Z. Vaknin

Authors
  1. Yaakov Melcer
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  2. R. Maymon
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  3. K. Krajden Haratz
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  4. I. Goldrat
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  5. M. Shavit
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  6. I. Ben-Ami
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  7. Z. Vaknin
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Contributions

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).

Corresponding author

Correspondence to Yaakov Melcer.

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Conflict of interest

We declare that all authors have no conflict of interest.

Ethical approval

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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Melcer, Y., Maymon, R., Krajden Haratz, K. et al. Termination of pregnancy due to fetal central nervous system abnormalities performed after 24 weeks’ gestation: survey of 57 fetuses from a single medical center. Arch Gynecol Obstet 298, 551–559 (2018). https://doi.org/10.1007/s00404-018-4836-z

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  • DOI: https://doi.org/10.1007/s00404-018-4836-z

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