Späte Schwangerschaftsabbrüche nach der 14. Schwangerschaftswoche: Indikation, Methodik und Komplikationen, eine retrospektive Analyse aus den Jahren 2008–2024

Background: The aim of this study is to present the medical indications, diagnostic procedures, fetal pathologies, and timing of abortions for medical reasons after the 12+0 week of pregnancy (p.c.) as well as to examine the influence of the introduction of NIPT on the timing and pattern of indications. Methods: Retrospective analysis of 561 abortions from the 12+0 week of pregnancy at a university hospital between 2008 and 2024. Diagnoses are based on ultrasound examinations, invasive prenatal diagnostic procedures, and molecular genetic analyses. Statistical evaluations were performed descriptively and inferentially. Results: The most common indications were chromosomal abnormalities (38.1%), followed by malformations of the CNS (22.4%) and multiple malformations (17.0%). Terminations of pregnancy before the 24+0 week of gestation occurred significantly earlier and more frequently in cases of chromosomal abnormalities, while malformations of the CNS dominated after the 24+0 week of gestation. Complications in the mother were rare overall (4%), no maternal deaths. The introduction of NIPT led to an earlier diagnosis of chromosomal abnormalities. Conclusion: Medically indicated abortions are safe and have a low complication rate in mothers. The most common indications relate to chromosomal abnormalities and malformations of the central nervous system. The introduction of NIPT tends to enable earlier diagnosis of fetal chromosomal abnormalities. Further long-term observations are necessary to fully assess the impact of NIPT.