Termination of pregnancy for congenital fetal malformations: a retrospective review in a tertiary care center

Abstract

Introduction: Congenital fetal anomalies are a significant cause of perinatal morbidity and mortality, affecting approximately 3% of pregnancies worldwide. This study aimed to evaluate the patterns of congenital anomalies, methods of detection, and outcomes of pregnancy termination.

Method: A retrospective study was conducted in the Department of Obstetrics and Gynaecology, Patan Hospital, Nepal, from April 2021 to March 2025. Medical records of 78 women who underwent termination of pregnancy for congenital fetal malformations were reviewed. Maternal demographics, diagnostic modalities, type of anomaly, time taken for decision-making, method of termination, and outcomes were analyzed.

Result: Most women were aged 21–30 years (71.8%), and 56.4% were primigravida. Fetal anomalies were most commonly diagnosed between 21 and 30 weeks of gestation (61.5%), predominantly during the anomaly scan (51.3%). Central nervous system anomalies were the most common (33.3%), followed by multisystem anomalies (30.8%) and congenital heart disease (19.2%). More than half of the women (51.3%) decided to terminate the pregnancy within three days of diagnosis. Medical termination was the predominant method (88.5%), followed by Foley’s catheter induction (7.7%). Most women achieved expulsion within 24 hours.

Conclusion: The anomaly scan was the most common diagnostic modality, with the central nervous system being the most frequently affected system. Medical termination was effective and feasible, with high success rates. Wider implementation of first-trimester screening and streamlined referral pathways may facilitate earlier diagnosis and management of congenital fetal anomalies.