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[Late pregnancy interruption in Noord-Holland. I. Incidence and abnormalities]
G van der Wal1, J M Bosma, S L Hosman-Benjaminse
1Inspectie voor de Gezondheidszorg voor Noord-Holland, Haarlem.
Objective:
To gain insight into the extent to which late termination of pregnancy (gestational age > 24 weeks) is practised and to find out what foetal diseases and abnormalities lead to termination.
Design:
An exploratory, descriptive, retrospective study.
Setting:
Province of North Holland, the Netherlands.
Methods:
An investigation, based on an anonymous printed questionnaire, was conducted among all associations/departments of gynaecologists in the 21 hospitals in North Holland. The period of study covered the years 1990 to 1994 inclusive.
Results:
Replies, in the form of completed questionnaires, were received from 19 associations/departments in the 21 hospitals (90% response). In the five-year period under study 103 pregnancies in 14 of the hospitals were terminated beyond the 24th week. In 21% of the cases anencephaly was diagnosed prior to the termination; another 21% of the foetuses were diagnosed as having severe chromosomal defects. Other severe abnormalities were neural groove defects like hydrocephaly and/or spina bifida (16%), no renal function (12%) and skeletal abnormalities (11%).
Conclusion:
Late termination of pregnancy appears to be practised on a substantial scale, at any rate in North Holland. The reasons for termination are severe structural abnormalities which in most of the cases are not compatible with extrauterine survival.