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Fetal Survival in Second-Trimester Termination of Pregnancy Without Feticide

Springer, Stephanie; Gorczyca, Monika, E.; Arzt, Julia; Pils, Sophie; Bettelheim, Dieter; Ott, Johannes

doi: 10.1097/AOG.0000000000002503
Contents: Original Research

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 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.

Clinical Division of Obstetrics and Fetomaternal Medicine and the Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, and the Department of Internal Medicine, Landesklinikum Klosterneuburg, Klosterneuburg, Austria.

Corresponding author: Johannes Ott, MD, Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, Wien 1090, Austria; email:

Financial Disclosure The authors did not report any potential conflicts of interest.

The authors thank Maximilian Schmid, MD, Senior Director of Medical Affairs, Roche, for his crucial input.

Each author has indicated that he or she has met the journal's requirements for authorship.

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.