Interruptions médicales de grossesse pour motifs maternels : étude rétrospective multicentrique des indications dans la période entre la loi sur l’interruption de grossesse de 2001 et la nouvelle loi de bioéthique

Abstract

To analyze the reasons for terminations of pregnancy (TOP) in cases of "severe jeopardy of the woman's health" beyond the limit of 14weeks, performed under the 2001 French law on abortion which extended these indications, until a new bioethics law was promulgated in 2011. A retrospective observational study of all TOP performed for maternal indications (excluding premature membrane rupture), following a medical decision, from 2001 to 2010 in four academic maternity units in northern Paris. One hundred and three patients were included. The incidence was approximately 1 per 1000 births. The mean gestational age at the time of the TOP was 21.5weeks (range 7.7-34.7); 7% occurred before 14weeks and 35% after 24weeks. Indications were: (1) maternal diseases (22%), (2) psychosocial indications (21%) in majority multiple drug addictions, (3) psychiatric indications (21%), (4) obstetrical complications (mainly preeclampsia) before fetal viability (20%) and (5) rape (16%) mostly on minors. In 16% of cases, several indications were associated. TOP for maternal indications remains exceptional, including for psychosocial indications. Our findings suggest that the French law on TOP was not misused in these centers to permit abortion on demand beyond the limit of 14weeks.