Paul Maurice1, Alexandra Letourneau2, Alexandra Benachi2,3, Jean-Marie Jouannic1,3. 1. Fetal Medicine Department, Trousseau Hospital, APHP Sorbonne, Sorbonne Université, Paris, France. 2. Obstetrics and Gynaecology Department, Antoine Béclère Hospital, APHP, Clamart, France. 3. Fédération Française des Centres Pluridisciplinaires de Diagnostic Prénatal, Paris, France.
Abstract
OBJECTIVE: To conduct an audit of the practice of feticide in second- and third-trimester termination of pregnancy for fetal anomalies (TOPFA) in prenatal diagnosis (PD) centers in France. RESULTS: A questionnaire was sent out to the 49 French PD centers and completed by 39/49 centers; 5350 TOPFAs were performed. The gestational age after which feticide was performed was 20 weeks in two centers (5%), 22 weeks in 28 centers (72%), 23 weeks in four centers (10%), and 24 weeks in five centers (13%). Fifteen of 39 centers reported that feticide was not performed in all cases, because of a fetal abnormality associated with a high probability of rapid neonatal death (13 centers), pregnant woman's refusal (11 centers), and technical impossibility of performing feticide (one center). Feticide was done using xylocaine in 38 of the 39 centers and using KCl in the remaining center. All but one of the centers before feticide used fetal anesthesia. Feticide was done on the day of induction of labor in 35/39 centers (90%), after maternal epidural analgesia in 33 centers, or after maternal subcutaneous local anesthesia in two centers. Feticide was done the day before induction of labor in two centers. CONCLUSION: In France, most TOPFAs performed in second and third trimesters are associated with feticide, which is most often done after fetal anesthesia.
OBJECTIVE: To conduct an audit of the practice of feticide in second- and third-trimester termination of pregnancy for fetal anomalies (TOPFA) in prenatal diagnosis (PD) centers in France. RESULTS: A questionnaire was sent out to the 49 French PD centers and completed by 39/49 centers; 5350 TOPFAs were performed. The gestational age after which feticide was performed was 20 weeks in two centers (5%), 22 weeks in 28 centers (72%), 23 weeks in four centers (10%), and 24 weeks in five centers (13%). Fifteen of 39 centers reported that feticide was not performed in all cases, because of a fetal abnormality associated with a high probability of rapid neonatal death (13 centers), pregnant woman's refusal (11 centers), and technical impossibility of performing feticide (one center). Feticide was done using xylocaine in 38 of the 39 centers and using KCl in the remaining center. All but one of the centers before feticide used fetal anesthesia. Feticide was done on the day of induction of labor in 35/39 centers (90%), after maternal epidural analgesia in 33 centers, or after maternal subcutaneous local anesthesia in two centers. Feticide was done the day before induction of labor in two centers. CONCLUSION: In France, most TOPFAs performed in second and third trimesters are associated with feticide, which is most often done after fetal anesthesia.