Current Trends Third-Trimester Induced Abortion -- Georgia,
1979 and 1980
During 1979 and 1980, third-trimester induced abortions*
reported
to Georgia's Department of Human Resources (DHR) accounted for
123.1
per 100,000 legal abortions (86 of 69,876). Because of concern
about
this reported number and the indications for late abortions, the
DHR
undertook a medical record review.
The DHR reviewed medical records and verified pregnancy
outcome**
for 78 (90.7%) of reported third-trimester induced abortions. Of
these 78 reports, three were for women who had true third-trimester
induced abortions. Two of these were performed to terminate
pregnancies involving anencephalic fetuses at 25 and 34 weeks'
gestation. The third woman had an abortion at 26 weeks' gestation,
but little information was available from which to determine the
reason for the procedure. Of the 78 reported to have obtained
third-trimester induced abortions, 58 (74.4%) were fetal deaths in
utero, while 15 (19.2%) were first- or second-trimester abortions;
one
was a duplicative report, and one was not an abortion. Thus, the
occurrence of true third-trimester-induced abortion was 4.3 per
100,000 legal abortions (3 of 69,876) instead of the reported
123.1.
Reported by JW Flynt, MD, M Lavoie, AK Schoenbucher, MD, Georgia
State
Dept of Human Resources; Program Evaluation Br, Div of Reproductive
Health, Center for Health Promotion and Education, CDC.
Editorial Note
Editorial Note: Abortions performed during the third trimester are
regulated by Georgia state law, which requires that a physician
file
an induced-abortion report with the DHR within 10 days of
performing
an abortion.
It is not clear why women who had fetal deaths in utero were
misclassified as having had induced abortions. However, since
almost
all these women had had labor induced to expel a dead fetus, many
attending physicians may report these events as induced abortions
rather than as fetal deaths in utero. Misclassification of first-
and
second-trimester abortions was almost entirely (14/15) due to
transcription, coding, or keypunching errors. Of the 15
misclassified
abortion reports, 12 represented women who had abortions at less
than
14 weeks' gestation.
Underdetection of true third-trimester induced abortions was
minimized by defining the third trimester as the period at 25 or
more
weeks' gestation, as opposed to the DHR's definition of more than
27
weeks' gestation. In addition to reviewing all reported induced
abortions at 25 or more weeks' gestation by physician estimate, the
DHR attempted to find additional cases by reviewing reports of
induced
abortions performed 25 or more weeks from the date of the last
menstrual period when physicians' estimates were either less than
25
weeks' or unavailable. During 1979 and 1980, the DHR record review
found no true third-trimester induced abortions among 143 such
reports.
Eight third-trimester abortions with unconfirmed pregnancy
outcomes were reported. Classification of these as true
third-trimester abortions would increase the rate of such abortions
from 4.3 to 15.7 per 100,000 abortions.
True third-trimester induced abortions are rare in Georgia. To
decrease overreporting such abortions, the DHR is informing
physicians
how to report induced pregnancy terminations more accurately. If
similar concerns exist in other states, CDC recommends periodic
verification of reported data.
Disclaimer
All MMWR HTML documents published before January 1993 are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.
**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.
