Objective: To evaluate fetal anomalies and processes leading to termination of pregnancy in the third trimester. Methods: The study includes all cases who underwent termination of pregnancy after 28 weeks of gestation due to fetal anomalies between 2017 and 2022. Results: Forty four of third trimester terminations were carried out in our clinic due to fetal anomalies incompatible with life or associated with severe sequelae. Structural anomalies including 35 (79.5%) cases were the most common reason of terminations followed by chromosomal or genetic abnormalities in 8 (18.2%) cases and intrauterine cytomegalovirus infection in 1 (2.3%) case. The processes leading to the third trimester termination were evaluated by dividing 44 patients into 5 groups. (1) Delayed diagnosis due to inadequate prenatal care (25 patients, 56.8%); (2) patients diagnosed with late-onset findings (5 patients, 11.4%); (3) patients with abnormal findings in prenatal care or history but delayed diagnosis (5 patients, 11.4%); (4) patients with abnormal findings requiring further evaluation (4 patients, 9.0%); (5) patients with a definitive diagnosis but latency in the decision of family for termination of pregnancy (5 patients, 11.4%). Conclusion: Termination of pregnancy in the third trimester has an important role in countries where unfollowed pregnancies are common and access to health services is poor due to low socio-economic status.
We aimed to compare the pre-termination quality of life (QoL) domains, depression and anxiety symptoms of women whose pregnancy will be terminated due to induced abortion and miscarriage (spontaneus abortion).
Material and Method:This prospective case-control study included women hospitalized for pregnancy termination less than 10 weeks old at a university hospital between January 2020 and December 2020. Self-evaluation questionnaires were presented to 35 women in the induced abortion group and 35 women in the miscarriage group. Women with chronic systemic diseases, those with known psychological disorders and therefore taking medication, women who were offered an abortion with the decision of the health board and who did not want to fill out the questionnaire were excluded from the study. For this, WHOQOL-BREF short-form quality of life questionnaire, Beck Depression and Anxiety Inventory were used to determine psychological stress levels before termination.Results: Moderate-severe depression symptoms were found to be statistically higher (31.4%, 5.7%, respectively) in induced abortion group than miscarriage group ( p<0.05). Similarly moderate-severe anxiety sypmtoms were 34.3% in the induced abortion group and 8.6% in the miscarriage group, and a statistical difference was observed (p<0.05). We found the lowest percentages in the environmental domain of QoL in both group. In terms of the psychological domain of QoL and the physical domain of QoL, we obtained statistically significantly lower results in the induced abortion group compared to the miscarriage group (p<0.05).
Conclusion:It was observed that women who had induced abortion were more prone to depression and anxiety before pregnancy termination than those who had miscarriage . The low level of environmental domain of QoL was noted in both groups, and the physical and psychological domains of QoL were found to be lower in the induced abortion group. Whether they have a pregnancy plan or not, we believe that supporting women of reproductive age with self-efficacyenhancing strategies and increasing their psychological resilience will benefit them in the early pregnancy problems and management they will encounter in the future.
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