THERAPEUTIC TERMINATION OF PREGNANCY IN PATIENTS WITH MEDICAL DISORDERS

Abstract

Objective: To study the reasons for therapeutic termination of pregnancy in the first and second trimester, and complications of the interventions and outcome. Methodology-P a t i e n t s wh o underwen t therapeutic termination of pregnancy from February 2001 to Apri l 2005 for medical indications were studied. Terminations of pregnancy for pregnancy induced hypertension were excluded from the study population. Results- Cardiac disease was the main reason for termination of pregnancy, and sixteen (76.19%) patients had pregnancy terminated because of serious maternal cardiac disease. In those cardiac Lesions eleven (68.75%) were ccnigenital in origin Among acquired cardio-vascular lesions two (13.3%) patients had dilated cardiomyopathyRheumatic ^valvular lesion, aortic aneurysm and primary pulmonary hypertension accounted to other three cases. No n cardiac medical problems were present in five (23.8%) patients who underwent termination. Those were renal disease, respiratory disease, and post thyroidectomy and post radio-iodine therapy. Six (28.57%) of the patients were primigravidae and others were multigravidae . Eleve n (52.38%) of the terminations were done in the first trimester. Medical induction, Dilatation and Evacuation, and hysterotomy were used as termination methods. There was one death of a patient with A S D associated with pulmonary hypertension following termination. Thirteen (61.9%) of the patients underwent permanent sterilization at the time of termination of pregnancy. Conclusion: According to this study it shows that there is a need for organized pre pregnancy counseling for patients with medical disorders to avoid pregnancy whe n it is medicall y contraindicated.