VALENCIA, Spain—The early diagnosis of fetal defects is important for the safety of the mother, according to Oliver Kagan, PhD, the head of prenatal medicine at Eberhard Karls University of Tübingen in Baden-Württemberg, Germany, since a significant proportion of women choose to terminate their pregnancy following such diagnoses.

It is known that the early diagnosis of fetal defects has many advantages, including more time for further testing and detailed counseling about the prognosis, fewer legal restrictions, selective reduction in dichorionic twin pregnancies, and more choice for women.

During his special lecture at the 20th World Congress in Fetal Medicine, Dr. Kagan presented the case of a woman in her mid-30s, who developed serious kidney insufficiency following the termination of her pregnancy, to illustrate the importance of early fetal defect diagnosis. 

The woman was in her second pregnancy and had had a Cesarean section in her previous pregnancy. Following the termination, she had massive bleeding of unclear origin, required 20 blood transfusions, had a hysterectomy and 3 re-operations, stayed in the intensive care unit for 5 days, and now requires lifelong dialysis. 

Dr. Kagan also presented data showing that the risk of complications such as heavy bleeding and infection is more common with induction, which is the method used to terminate pregnancies in the second and third trimester, compared to surgical termination with vacuum aspiration, the method of choice during the first trimester.

A significant predictor of complications is increased gestational age, which rises by 6% every week, Dr. Kagan said. 

Every year, 73 million pregnancies are terminated worldwide and almost half of the terminations are done in developing countries and are unsafe. The death rate due to termination of pregnancy is around 220 per 100,000 births in developing countries and around 30 per 100,000 in Western countries.

Reference

Kagan O. Complication rate after termination for fetal defects. Oral presentation at: 20th World Congress in Fetal Medicine; June 28, 2023; Valencia, Spain.