EP10.10: Outcomes of feticide followed by late termination of pregnancy at a tertiary hospital in the UK

Describe the trends and outcomes of feticide followed by late termination of pregnancy (TOP) at a tertiary hospital in the UK. Retrospective audit of 99 cases- 70 feticide performed between 01/01/2016 – 31/12/2020 (5 years), followed by re-audit of 29 cases between 01/01/2023 – 31/12/2023 (1 year). The median number of feticides per year was 14 (range 12-16) between 2016 and 2020 with a significant increase to 29 in 2023. The median gestation at feticide has increased from 22+2 weeks (range 19+5-35+1) in the last 5 years to 24 weeks in 2023. Neurological (35%) and cardiac (17%) abnormalities were the two most frequent indications for TOP amongst all 99 cases. Due to improved documentation, complete procedure details were available in all cases (100%) in 2023 cohort as opposed to in 67% cases in the previous 5 years. In most cases, 1% lidocaine was used: intracardiac injection in 94% (93/99 cases) and intraumbilical in 3% (3 cases). Intracardiac KCL was used in two cases (2%) and both intracardiac lidocaine and KCL in one case (1%). Notes were available for 58 patients who subsequently underwent medical (n = 56) or surgical TOP (n = 2). The average misoprostol to delivery interval for patients undergoing medical TOP was 9h 20m. Complications occurred in 12 patients (21%). 10 women (17%) required surgery for a retained placenta, one had a massive hemorrhage, one uterine rupture in a patient with a previous Caesarean section. Surgical management involved hysterotomy in two cases- one following unsuccessful medical management and second in a case of previous Caesarean sections with possible scar implantation. Our findings show a rise in the number of feticides and late TOP for fetal anomaly, this could be due to introduction of exome sequencing. Following feticide most patients underwent MTOP, with complication rates consistent with those reported in the literature.