Severe Fetal Abnormality and Outcomes of Continued Pregnancies: A French Multicenter Retrospective Study
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Severe Fetal Abnormality and Outcomes of Continued Pregnancies: A French Multicenter Retrospective Study Marine Bourdens1 · Julie Tadonnet1 · Laura Hostalery2 · Laurent Renesme3 · Barthélémy Tosello2,4
© Springer Science+Business Media, LLC 2017
Abstract Objectives To describe a population choosing to continue with their pregnancy despite being eligible to receive a medical termination of pregnancy (TOP). Methods Nine-year retrospective study of data (01/01/2006 to 31/12/2014) from three French prenatal diagnostic centers describing the perinatal outcomes of these pregnancies. Pregnancies were classified according to etiology and severity of its fetal pathology. Several perinatal parameters were described: maternal characteristics, parental prenatal choices and information on the pregnancy and neonatal outcomes. These parameters were classified in function of the severity of fetal pathology according to the classification proposed by Dommergues et al. (Prenatal Diagnosis 30(6):531–539, 2010) Results Overall, 155 pregnancies were continued; 140 have been included in our study. Pregnancy outcomes consisted of four TOPs (2.9%); 20 in utero deaths (14.3%); 110 live births (78.6%) of which 55.4% were still alive at 2 years old as the most recent information; and 6 (4.2%) with unknown outcomes. In 27 cases, perinatal palliative care was requested (an increase of 37% over 9 years). 36.4% of cases were classified as having a * Marine Bourdens [email protected] 1
Équipe Ressource Régionale de Soins Palliatifs Pédiatriques Aquitaine, Groupe Hospitalier Pellegrin, Hôpital des Enfants, Place Amélie‑Raba‑Léon, 33076 Bordeaux Cedex, France
2
Service de Néonatologie et Soins Intensifs, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, 13015 Marseille, France
3
Service de Néonatologie, Maternité, Centre Aliénor‑d’Aquitaine, CHU de Bordeaux, 33000 Bordeaux, France
4
UMR 7268 ADÉS/EFS/CNRS, Aix-Marseille Université, 13005 Marseille, France
high mortality risk; 19.3% with a severe handicap risk; 11.4% with a risk of isolated intellectual disability; and 32.9% with an uncertain prognosis. The parental decisions to choose perinatal palliative care were significantly higher within the high mortality risk group as compared to other severity groups (p
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