Termination of pregnancy for fetal anomaly in a Tunisian population

Abstract

Background. Progress in prenatal diagnosis and prenatal screening in the past 2 decades has facilitated improved diagnostic methods for fetal abnormalities.

Objectives. To assess the indications for late termination of pregnancy, gestational ages and to discuss ethical and legal considerations.

Methods. A retrospective study compiling and analysing data from justified medical terminations of pregnancies, reported between January 2001 and June 2012 at Charles Nicolle Hospital. Congenital infectious embryofetopathies were excluded.

Results. Over this period, there were 77 cases of clinically justified medical terminations of pregnancies – a rate of 1.9 per 1 000 total births. The mean gestational age was 27 weeks. In 33 cases, the medical abortion was performed beyond 26 weeks (42.8%). Fetal malformations were predominantly of the central nervous system.

Conclusion. Medical terminations of pregnancy for fetal indications are relatively rare. However, they raise ethical, medical and legal issues, due in part to a late prenatal diagnosis. Such decisions should be taken through a multidisciplinary committee.