Termination of pregnancy for fetal abnormality: an audit of process and outcomes

Abstract

This study used an audit methodology to describe the processes and outcomes of induction of labour to terminate a pregnancy following the diagnosis of a fetal abnormality or a mid- trimester fetal demise. Currently there are no national or local databases established that provide an overview of the experiences of women who undergo termination of pregnancy for a fetal abnormality, or how the process is managed. There is no current data collected on whether there are any short or long term adverse physical or psychological outcomes associated with the procedure. This study begins to address that gap by providing an audit of all women undergoing the procedure at one health service in New Zealand from January 2002 to April 2003. Seventy sets of notes were audited and data relating to the process and outcomes of the termination of pregnancy were entered onto an Excel spreadsheet prior to being transferred to SPSS for analysis. The audit aimed to describe the processes and outcomes for women in one health service. In doing so the audit aimed to identify any patterns in the relationships between process and outcome and in particular to explore issues surrounding the timing of the start of the procedure following a diagnosis of a fetal abnormality. While no significant relationships were found women's comments on their experiences suggest the service could be improved in several ways. Psychological counselling and postnatal visits by a midwife could be among service improvements.