Termination of pregnancy without feticide: A French national survey. [French]

Abstract

Purpose. – Termination of pregnancy without feticide (TOPWF) is poorly known in France and far less practiced than palliative care after term birth of a child having a lethal pathology. Few teams consider it and its practice remains confidential. This survey tries to describe it. Material and methods. – A national survey was realized in 2014 using a questionnaire sent to50 centers of prenatal diagnosis depending on a perinatal diagnosis center in France. Results. -Thirty-one centers answered the questionnaire. Seven teams shared their experience of TOPWF after 22-24 weeks gestation (WG). This practice concerned fetuses affected by “lethal” pathologies. The absence of feticide followed a parental request or a proposal of the medical team, after individual discussion in a multidisciplinary meeting. All the children born alive after TOPWF benefited of palliative care. The 24 other centers having answered our investigation performed systematically the feticide beyond 22-24 WG. They so wished “to protect” the fetus, the parents and the nursing team. A majority of these teams faced parental demands of abstention of feticide but few of them answered it favorably. Conclusion. -A robust “palliative culture” seems essential to allow the nursing team to consider the development of TOPWF.