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Fetopathologic examination for early termination of pregnancy: dogma or necessity?



Fetopathologic examination for early termination of pregnancy: dogma or necessity?

Laurence Gitz, MD, Suonavy Khung-Savatovsky, MD, Géraldine Viot, MD, Julia Tantau, MD, Gilles Grangé, MD, Fanny Lewin, MD, Anne-Lise Delezoide, MD, PhD, Jean-François Oury, MD, Vassilis Tsatsaris, MD, PhD

American Journal of Obstetrics & Gynecology,
205:5, June 27, 2011

Fetopathologic examination for early termination of pregnancy: dogma or necessity?

Objective
Our objective was assessment of fetopathological examination after termination of pregnancy (TOP) for fetal anomalies with normal karyotype <17 weeks of gestation.


Study Design
This was a multicenter retrospective study. Records of TOP for fetal anomalies with normal karyotype were analyzed. Primary outcomes were modifications of genetic counseling and management of next subsequent pregnancies. Medical TOPs were compared with surgical TOPs.


Results
In all, 59 pregnancies were included (30 aspirations, 29 inductions). Fetopathological examination modified genetic counseling for 22 patients: 62% for the medical induction group vs 13% in the vacuum aspiration group (P < .001). Management of subsequent pregnancies was modified in 17% in the medical induction group vs 3% in the aspiration group (P = .06).

 

Conclusion
Fetopathological examination for early TOP with normal karyotype is relevant, especially when an intact fetus is examined. Thanks to it, genetic counseling is often modified, as is management of the next pregnancy. Medical procedures should be preferred to surgical procedures.







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Prepared by: Dr. Houssam Al-Nahhas






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