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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

Holger Lebek
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 ©akademos Wissenschaftsverlag 2013 ISSN 1614-8533