Patient perspective regarding late termination of pregnancy at a tertiary care Hospital

Archana Kumari, Hephzibah Kirubamani N., Vaanathi Ramu
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Abstract

To arrive at an understanding about the view and attitudes of pregnant women regarding late termination of pregnancy after prenatal  diagnosis of a severe fetal anomaly. A semi-structured questionnaire based prospective descriptive study was conducted from January  2022 to September 2022 in Obstetrics and Gynecology department of Saveetha Medical College and Hospital, Thandalam. 16 pregnant  women with severe fetal anomalies detected after 23 weeks were included. All the women were counselled about the type and lethality of the anomaly including management option. Informed consent was obtained from all the patients and ethical approval was obtained. A total of 16 women with congenital anomalies in fetus detected after 23 weeks of gestation over 8 months of the study period were  included in the study. All the participants were properly counselled and given adequate time to make the decision. Among which 11  decided to terminate the pregnancy and 5 continued. All 11 who opted for termination of pregnancy was joint decision by the family. 5  women continued their pregnancy. Reasons to continue the pregnancy were praying that baby will born normal (n=1), hoping that  surgery can correct the abnormality (n=3) and wanting to see the baby (n=1). This study shows that women who are pregnant with  serious fetal anomalies have a range of opinions and attitudes regarding termination. To compare with initial decision making larger  follow-up studies will be necessary to see whether patient’s perspective changes over time. 
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三级护理医院晚期终止妊娠的患者观点
了解孕妇在产前诊断严重胎儿畸形后对晚期终止妊娠的看法和态度。本研究于2022年1月至2022年9月在Thandalam Saveetha医学院和医院妇产科进行了一项基于半结构化问卷的前瞻性描述性研究,纳入了16名在23周后发现严重胎儿异常的孕妇。所有妇女都被告知异常的类型和致死率,包括治疗方案。所有患者均获得知情同意并获得伦理批准。在8个月的研究期间,共有16名妊娠23周后发现胎儿先天性异常的妇女被纳入研究。所有参与者都得到了适当的咨询,并有足够的时间做出决定。其中11人决定终止妊娠,5人继续妊娠。所有选择终止妊娠的11人都是由家庭共同决定的。5名妇女继续怀孕。继续妊娠的原因有:祈祷孩子能正常出生(n=1),希望手术能纠正异常(n=3),希望见到孩子(n=1)。本研究表明,严重胎儿畸形的孕妇对终止妊娠有不同的看法和态度。为了与最初的决策进行比较,有必要进行更大规模的后续研究,以了解患者的观点是否会随着时间的推移而改变。
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