Therapeutic abortion for maternal indications or how to reduce them?
Ben Amor Anissa1 ,2, Dimassi Kaouther1 ,2, Ben Aissia Nizar1 ,2, Triki Amen1 ,2
1Mongi Slim Hospital, La Marsa, Tunis, Tunisia, 2University Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
Background: Maternal medical conditions are an important reason for therapeutic abortions. Indeed several medical diseases may deteriorate or even develop during pregnancy.
Aim : The purpose of the study was to assess the reasons for therapeutic abortion for maternal indications in our department and to determine how to reduce them.
Methods: We conducted a retrospective study in the Mongi Slim Gynecology and Obstetrics department, La Marsa, Tunisia from 2005 to 2015. All cases of therapeutic abortion were included.
Results: There have been 127 therapeutic abortions done in 10 years, 32 of them were for maternal indications. The incidence was about 1 per 1000 births. The gestational age varied from 9 to 26 weeks' amenorrhoea. The causes were: obstetric diseases (12%), mainly severe preeclampsia (7%) and premature rupture of membranes (5%); maternal severe heart diseases (5%), mainly valvulopathies; maternal somatic diseases (2 cases : lupus and severe diabetic ketoacidosis); 8 cases (7%) of maternal cancer discovered while pregnant (5 cases of breast cancer, 1 of lung cancer and 2 of digestive cancer); and psychiatric conditions.
Conclusions: A quarter of therapeutic abortions done in our department were for maternal indications. It seems that chronic diseases not adequately followed up or diagnosed while pregnant are a major cause of therapeutic abortion despite the high frequency of obstetric causes. It is very important to encourage preconception consultations to improve the screening of these diseases and plan the pregnancy care properly. However, pregnancy still constitutes the only opportunity to have a detailed full check-up and to diagnose many diseases.