Comparison of induction-to-expulsion interval during second-trimester medication abortion in pregnancies with anencephaly and other congenital anomalies compared to those without anomalies: A retrospective cohort study

Abstract

To investigate whether induction to expulsion interval during second-trimester medication abortion in pregnancies complicated by anencephaly or other fetal anomalies is prolonged compared to pregnancies without fetal anomalies STUDY DESIGN: This was a retrospective cohort study of women who had second-trimester medication abortion at St. Paul's Hospital Millennium Medical College (Addis Ababa, Ethiopia). We assigned subjects to one of three groups based on fetal diagnosis: 1) anencephaly group 2) other congenital anomaly group 3) no anomaly group. Data were collected by reviewing patients' charts. We used SPSS version 23 to analyze the data. Simple descriptive analysis and Chi-squared test were performed as appropriate. A total of 303 women had second trimester medication at 14-28 weeks, of which 58 had anencephaly, 19 had congenital anomalies other than anencephaly, and the remaining 226 had no fetal anomalies. There was no difference in induction to expulsion interval among the groups. The mean induction to expulsion interval was 18.4 hours in the anencephaly group vs, 19.4 hours in the other congenital anomaly group vs. 19.2 hours in those without anomaly (p-value=0.924). The 24-hours non-expulsion rate was also comparable among the groups, with 5.25% rate of non-expulsion in the anencephaly group vs 15.8% in the other congenital anomaly group vs 11.15 % in the no anomaly group, (p-value=0.594). In multivariable regression analysis after controlling for parity, the 24-hour non-expulsion rate was not significantly different. In this study, pregnancies undergoing second-trimester medication abortion for fetal anomalies had comparable induction to expulsion interval and 24-hour expulsion rates compared to those who had the same procedure for other or no anomalies. Second-trimester medication abortion procedure length in pregnancies complicated by anencephaly is similar to those pregnancies without anomalies. All data generated or analyzed during this study are included in this published article.