Termination of pregnancy for medical indications: A 14-year analysis from a tertiary referral center.

OBJECTIVE

This study aimed to evaluate the medical indications for termination of pregnancy, gestational age at termination, and methods used in our clinic.

METHODS

This observational retrospective study included pregnancy terminations after 10 weeks of gestation for medical indications between 2010 and 2024. The indications were categorized into fetal, obstetric, and maternal groups. The mode of delivery and methods used for induction of labor were compared according to gestational age.

RESULTS

Of 954 pregnancy terminations, 685 (71.81%) had fetal indications, 238 (24.95%) had obstetric indications, and 31 (3.24%) had maternal indications. A total of 149 (15.62%) were ≥24 weeks of gestation. The median gestational age at termination in the maternal indication group was 14 weeks, significantly lower than other groups (P < 0.001). Central nervous system anomalies were the most prevalent indication for termination (n = 298, 31.24%). The mode of delivery was vaginal in 96.43% of the patients. The requirement for additional methods of labor induction beyond misoprostol was significantly higher in pregnancies ≥24 weeks of gestation (P < 0.001).

CONCLUSION

Major fetal anomalies are the most common reason for pursuing termination of pregnancy, however, the relevance of obstetric and maternal considerations must also be acknowledged. Additional interventions to misoprostol may be required for induction of labor beyond 24 week threshold.