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The effect of a policy change on late termination of pregnancy in Israel
Authors:Amir Aviram  Ami Fishman  Maya Steinberg  Ido Solt  Rami Aviram
Affiliation:1. Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel;2. Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel;3. Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel;4. Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel;5. Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
Abstract:

Objective

To compare approval rates of late termination of pregnancy (LTOP) requests before and after a policy change in Israel in late 2007.

Methods

In a retrospective study, LTOP requests and board decisions from 2002–2007 (group 1) were compared with those from 2007–2012 (group 2) at 3 university-affiliated medical centers in Israel. Reasons for application, approval, or rejection were compared between the groups.

Results

There were 552 applications for LTOP. The overall approval rate for LTOP and the specific approval rate per medical indication did not differ significantly between the groups. The rate of requests due to confirmed genetic anomalies decreased from 18.4% in group 1 to 11.3% in group 2 (P = 0.03). Compared with group 1, the rate of rejection for intrauterine infection increased from 8.3% to 26.3% (P = 0.2), and that for pregnancy complications decreased from 62.5% to 35.0% (P = 0.2) in group 2 but these differences were not statistically significant. Requests due to structural anomalies were declined because they were considered to be minor cardiac, renal, cerebral, or skeletal anomalies.

Conclusion

The more stringent 2007 criteria for approving requests for LTOP did not affect the rate of rejection of requests due to structural anomalies between the 2 time periods.
Keywords:Fetal anomalies   Prenatal diagnosis   Termination of pregnancy
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