Fetal Survival in Second-Trimester Termination of Pregnancy Without Feticide

Abstract

OBJECTIVE: 

To evaluate the rate of live birth and the duration of survival after termination of pregnancy without feticide.

METHODS: 

We conducted a retrospective analysis of 241 terminations of pregnancy without feticide for fetal anomalies or genetic abnormalities between 20 0/7 and 24 0/7 weeks of gestation at a single tertiary care referral center in Europe between February 2003 and May 2017. A multivariate binary regression model was used to evaluate factors associated with live birth.

RESULTS: 

Pregnancies were terminated at a mean gestational age of 22.1±1.1 completed weeks of gestation. Median birth weight was 440 g (range 141–1,890 g). Live birth occurred in 122 cases (50.6%, 95% CI 44.4–56.8); median survival time was 32 minutes (range 1–267 minutes). Factors associated with live birth were gestational age at labor induction (odds ratio 1.41, 95% CI 1.01–2.01; P=.049) and fetal anomalies (P=.046).

CONCLUSION: 

After termination of pregnancy without feticide between 20 0/7 and 24 0/7 weeks of gestation, the live birth rate was 50.6% (95% CI 44.4–56.8). A lower gestational age at labor induction and the presence of skeletal, cerebral, renal, or multiple fetal anomalies increased the chance of stillbirth.

In Brief

In termination of pregnancy between 20 0/7 and 24 0/7 weeks of gestation (inclusive) without feticide, 50.6% (95% CI 44.4–56.8) of fetuses show signs of life, with a median survival time of 32 minutes.