LATE SELECTIVE TERMINATION OF FETAL ABNORMALITIES IN TWIN PREGNANCIES- A MULTICENTER REPORT

Objective To evaluate the outcome of late selective fetal termination based on combined data from eight tertiary perinatal centres. Design I sraeli law requires institutional committee approval for pregnancy ter mination. Moreover, after 24 weeks only a district superior committee can approve the termination. A total of 36 bichorionic twin pregnancie s who underwent selective fetal termination after 24 complete gestatio nal weeks were identified in eight Israeli centres. Results In 23 wome n (63.9%) the indication for selective termination was structural anom aly, and in 13 (36.1%) the indication was chromosomal abnormality. The mean gestational age at the time of diagnosis was 24.1+/-1.9 weeks. T he termination procedure was performed at a mean gestational age of 25 .5+/-2.0 weeks (median 25, range 24-33 weeks). There was one case of i mmediate procedure-related complication (i.e. amnionitis) and the unaf fected infant died, which was the only perinatal death in this series. No evidence of coagulopathy was reported. Only five women (13.8%) del ivered before 34 completed weeks. The mean gestational age at delivery was 36.9+/-2.9 weeks (28-41 weeks), and the mean procedure-to-deliver y interval was 11.8+/-3.2 weeks (median 13, range 3-17 weeks).Conclusi ons Late (> 24 weeks) selective termination in twin pregnancies is ass ociated with favourable perinatal outcome of the healthy twin. In coun tries where the law permits late pregnancy termination, the parents sh ould;be informed of that possibility.