Late abortions – implementation and legal aspects
Late termination of pregnancy (LTOP) at or above the limit
of viability are exceptional situations for pregnant women
and also for physicians. The percentage of LTOP to the total
number of pregnancies (births and reported abortions) in
Germany was 2010: 0.0586% and its part of the number of
reported fetal demises 0.42%.
Condition for the implementation of LTOP is a certified
medical and social) indication (MSI) from a physician. This
is supposed to avert a danger to life or serious impairment
of the physical or mental health of the pregnant woman,
taking into account current and future living conditions,
under medical assessment. Just in a rare number of cases
an acute danger of life is given. Trigger for the MSI is in
most cases the diagnosis of a nonviable serious fetal
disease and/or is associated with significant permanent
restrictions for child and mother.
For pregnant women and affected couples the decision
for or against a severely disabled child is both an extreme
emotional and physical stress, also to the partnership.
After 21 week feticide is necessary to ensure the fetus did
not survive LTOP. To follow the law by working in this context,
a high number of legal, medical and ethical aspects
have to be considered and respected.
CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol
2013; 9(3): 220–237
Termination of pregnancy (TOP), fetocide, late abortion,
fetal anomalies, potassium chlorid
Praxis für Pränatale Diagnostik, Berlin
Reviewer: Christoph Berg, Köln und Bonn,
und Rainer Bollmann, Berlin
Lebek H. Späte ... Gynakol Geburtsmed Gynakol Endokrinol 2013; 9(3): 220–237 publiziert 30.11.2013 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2013 ISSN 1614-8533