Search

Objectives To ascertain the incidence and demographic data of TOP for hypertensive disorders at the limits of fetal viability. Methods We conducted a retrospective cohort study. All terminations for hypertensive disorders between 2000 and 2009 in the ten Dutch tertiary care centers with a gestational age between 22 and 28 weeks were included. In all cases the fetus was judged to be non-viable, either because of the low gestational age or because of the effects of the maternal condition on the fetus. There was no intention to intervene for fetal indications. Results During the study period TOP for hypertensive disorders occurred in 0.8 promille (131/163.052) of all deliveries in these 10 centers, of which there were 126 singleton and five twin pregnancies. 94 women were nulliparous and 37 multiparous. The main indication for TOP was HELLP syndrome. General history revealed hypertension in 24 women (18.3%). History was unremarkable in 98 cases (75%). The mean gestational age at admission was 166 days ± 9.6 days (GA 23+5), and at delivery this was 173 days ± 9.7 days (GA 24 + 5 weeks). The mean birth weight was 472 ± 123 g (70% < p10). The overall perinatal mortality was 99.3%. There were no maternal deaths. Conclusions In 10 years there we identified 131 cases of TOP for hypertensive disorders prior to fetal viability in The Dutch tertiary care centers. Ninety-eight women (75%) had no preexisting maternal disease. Table 1. Indications for termination of pregnancy. N = number. Indication N (%) HELLP syndrome 80 (61.1) Preeclampsia 40 (30.5) Eclampsia 7 (5.3) Refractory hypertension 4 (3) Disclosures L. van Eerden: None. [ABSTRACT FROM AUTHOR]