1 Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan

2 Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran


BACKGROUND: Some risk factors that would lead to therapeutic abortion do even exist before
pregnancy and could be resolved or corrected through appropriate interventions. The present study
was conducted to evaluate the condition of preconception care among therapeutic abortion applicants.
MATERIALS AND METHODS: This research was a descriptive, cross‑sectional study that was
conducted on 200 applicants for therapeutic abortion at the Forensics Medicine Center of Isfahan (Iran)
who were selected convenience sampling from October 2014 to March 2015. Data were gathered
using a researcher made checklist. Data were analyzed using SPSS version 16 through descriptive
statistics and Chi‑square and independent t‑test.
RESULTS: Eighty‑five percent of the participants were applicants for therapeutic abortion due to
fetal problems, and the other 15% were due to maternal issues. About 41.7% of participants with
fetal problems and all of the participants with maternal issues had not received preconception care.
In 93.3% of the applicants with maternal issues, the disease existed before the pregnancy. About
48.2% of participants needed genetic counseling, but 28.6% had not received any.
CONCLUSIONS: Results showed that in most of the participants, the risk factor for therapeutic
abortion existed before the pregnancy. Providing preconception care along with the elimination
of risk factors before the pregnancy could prevent some of the pregnancies with the indication of
therapeutic abortion.


1. Jotkowitz A, Zivotofsky AZ. The ethics of abortions for fetuses
with congenital abnormalities. Eur J Obstet Gynecol Reprod Biol
2. Akrami S, Bastani A, Osati Z. Avoiding medical error in
therapeutic abortion. Iran J Med Ethics Hist Med 2010;3:55‑8.
3. Larijani B, Zahedi F. Changing parameters for abortion in Iran.
Indian J Med Ethics 2006;3:130‑1.
4. Seyedalshohadaie F, Zandevakili F, Yousefnezhad V, Gharibi F.
Investigation cause of therapeutic abortion in Sannadaj forensic
medicine clients. Sci J Kurdistan Univ Med Sci 2011;16:46‑50.
5. Asplin N, Wessel H, Marions L, Georgsson Öhman S. Pregnancy
termination due to fetal anomaly: Women’s reactions, satisfaction
and experiences of care. Midwifery 2014;30:620‑7.
6. Ramsey PS, Owen J. Midtrimester cervical ripening and labor
induction. Clin Obstet Gynecol 2000;43:495‑512.
7. Hadar E, Ashwal E, Hod M. The preconceptional period as an
opportunity for prediction and prevention of noncommunicable
disease. Best Pract Res Clin Obstet Gynaecol 2015;29:54‑62.
8. Samadirad B, Khamnian ZH, Hosseini MB, Dastgiri S.
Congenital anomalies and termination of pregnancy. J Pregnancy
9. Moosazadeh M, Nekoei‑Moghadam M, EmraniZ, Amiresmaili M.
Prevalence of unwanted pregnancy in Iran: A systematic review
and meta‑analysis. Int J Health Plann Manage 2014;29:e277‑90.
10. Chuang CH, Hillemeier MM, Dyer AM, Weisman CS. The
relationship between pregnancy intention and preconception
health behaviors. Prev Med 2011;53:85‑8.
11. Chuang CH, Velott DL, Weisman CS. Exploring knowledge
and attitudes related to pregnancy and preconception health in
women with chronic medical conditions. Matern Child Health J
12. Steel A, Lucke J, Adams J. The prevalence and nature of the use of
preconception services by women with chronic health conditions:
An integrative review. BMC Womens Health 2015;15:14.
13. Bixenstine PJ, Cheng TL, Cheng D, Connor KA, Mistry KB.
Association between preconception counseling and folic acid
supplementation before pregnancy and reasons for non‑use.
Matern Child Health J 2015;19:1974‑84.
14. D’Angelo DV, Le B, O’Neil ME, Williams L, Ahluwalia IB,
Harrison LL, et al. Patterns of health insurance coverage
around the time of pregnancy among women with live‑born
infants – Pregnancy risk assessment monitoring system, 29 states,
2009. MMWR Surveill Summ 2015;64:1‑19.
15. Mazza D, Chapman A, Michie S. Barriers to the implementation
of preconception care guidelines as perceived by general
practitioners: A qualitative study. BMC Health Serv Res
16. Bayrami R, Ebrahimpour H, Ebrahimi M, Froutani MR,
Najafzadeh B. Health care providers knowledge – Attitude and
practice regarding preconception care. J Res Health 2013;3:519‑26.
17. Sabine F, Sevilary T, Amber A, Rachel B, Semiha D, Eric A. The
association between preconceptional risks factors and adverse
pregnancy outcomes. In: Denktaş S, Jong-Potjer LC, WaelputAJ,
Temel S, Voorst van SF, Vos AA, et al. Preconception Care a
Review of the Literature. First draft University Medical Centre
Rotterdam, Erasmus MC: The Netherlands; 2012. p. 33-41.
18. Dunlop AL, Gardiner PM, Shellhaas CS, Menard MK,
McDiarmid MA. The clinical content of preconception care:
The use of medications and supplements among women of
reproductive age. Am J Obstet Gynecol 2008;199 6 Suppl 2:S367‑72.
19. Deng K, Liu Z, Lin Y, Mu D, Chen X, Li J, et al. Periconceptional
paternal smoking and the risk of congenital heart defects:
A case‑control study. Birth Defects Res A Clin Mol Teratol
20. Nekuei N, Kazemi A, Hasanzadeh A. Preconception interventions
in infertile couples. J Educ Health Promot 2014;3:101.
21. Lassi ZS, Imam AM, Dean SV, Bhutta ZA. Preconception care:
Screening and management of chronic disease and promoting
psychological health. Reprod Health 2014;11 Suppl 3:S5.
22. Nelson CR, Leon JA, Evans J. The relationship between awareness
and supplementation: Which Canadian women know about folic
acid and how does that translate into use? Can J Public Health
23. Hartridge T, Illing HM, Sandy JR. The role of folic acid in oral
clefting. Br J Orthod 1999;26:115‑20.
24. Nikuei P, Malekzadeh K, Mahdizadeh R, Mahdizadeh RA,
Hajizadeh F, Zahedi F. Genetic counseling in South of Iran. Am
J Life Sci Res 2015;3:144‑7.
25. Zhao X, Jiang X, Zhu J, Li G, He X, Ma F, et al. Factors influencing
the quality of preconception healthcare in China: Applying a
preconceptional instrument to assess healthcare needs. BMC
Pregnancy Childbirth 2014;14:360.
26. Temel S, Birnie E, Sonneveld HM, Voorham AJ, Bonsel GJ,
Steegers EA, et al. Determinants of the intention of preconception
care use: Lessons from a multi‑ethnic urban population in the
Netherlands. Int J Public Health 2013;58:295‑304.