The following are the medical and social indications for artificial termination of pregnancy, the presence of which is a necessary condition for performing artificial termination of pregnancy between 12 and 22 weeks of gestation:
1. Social indications for artificial termination of pregnancy are exhaustively defined by current legislation. They are:
1) the death of the husband during pregnancy.
2) the wife or husband serving a sentence in a penal institution as prescribed by law.
3) divorce during pregnancy as prescribed by law.
4) pregnancy resulting from rape:
Documents confirming the social indication are: in the case of the husband's death, a copy of the death certificate; in the case of the wife or husband serving a sentence in a penal institution or in the case of rape, a copy of the court's legally binding judgment; in the case of divorce, a copy of the divorce certificate:
2. Medical indications for artificial termination of pregnancy are related to pathologies incompatible with the life of the pregnant woman or fetus (child) or defects/diseases that cannot be corrected.
Medical indications are divided into two groups: medical indications related to the woman's condition and medical indications related to the pathological condition of the fetus or child:
a) Medical indications related to the woman's condition are:
1) infectious and parasitic diseases (A00-B99) (termination is performed after the acute condition has passed):
a. all active forms of tuberculosis (A15-A19),
b. severe forms of viral hepatitis (B15-B19),
c. all forms of syphilis (A51.0),
d. rubella (B25-B34),
e. presence of human immunodeficiency virus or acquired immunodeficiency syndrome (B20-B24).
2) Malignant neoplasms:
a. presence of malignant neoplasms of any localization currently or in the past (C00-C90),
b. malignant neoplasms of the lymphatic and hematopoietic systems (C81-C96).
3) Endocrine system diseases, nutritional and metabolic diseases (E00-E90):
a. moderate and severe forms of thyrotoxicosis (E00-E07),
b. decompensated form of congenital or acquired hypothyroidism (E20-E35),
c. severe form of diabetes mellitus (E10-E14),
d. severe course of adrenal gland damage (E27).
4) Diseases of the hematopoietic organs and blood with frequent exacerbations, severe course (D50-D89):
a. aplastic anemia (D60-D64),
b. vasopathies (Verl-Hoff, Schaylen-Henoch diseases) (D65-D69).
5) Mental disorders (F00-F99):
a. manic-depressive psychoses, schizophrenia, or other mental disorders with incapacity to make decisions (F00-F99),
b. intellectual disability (F70-F79).
6) Diseases of the nervous system and sensory organs (G00-G99):
a. acute inflammatory diseases of the central nervous system (meningitis, encephalitis, myelitis, meningoencephalitis, etc.) (G00-G09),
b. hereditary and degenerative diseases of the nervous system and other types of organic lesions (G30-G32),
c. epilepsy (G40),
d. inflammatory and toxic neuropathy (G60-G64),
e. muscular dystrophies and other forms of myopathies (G70-G73),
f. diseases of the visual system accompanied by blindness or a decrease in visual acuity and/or narrowing of the visual field that cannot be corrected (H53-54),
g. diseases of the vestibular apparatus accompanied by treatment-resistant vertigo syndrome (H80-H83),
h. congenital, hereditary deafness (H91.3).
7) Cardiovascular diseases (I00-I99):
a. cardiovascular diseases accompanied by 3rd or 4th degree circulatory failure (I26-I28),
b. systemic diseases, collagenoses in the active phase, severe course (I00-I02),
c. hypertension of 2nd or 3rd degree (I10-I15),
d. heart rhythm disorders, atrial and ventricular fibrillation and flutter (I44.0-I47.0),
e. aortic aneurysm (I71.0),
f. embolism and thrombosis of blood vessels (I26.0),
g. congenital and acquired heart defects with circulatory failure (I50.0),
h. restenosis after mitral commissurotomy with pulmonary hypertension (I27.2),
i. primary pulmonary hypertension (I27.0).
8) Respiratory organ diseases (J00-J99):
a. stenosis of the airways, bronchi, larynx with severe course (J00-J06),
b. severe forms of bronchial asthma (J45),
c. severe forms of bronchiectasis (J47),
d. diseases of the lungs and pleura with pulmonary heart failure (I50.1-I50.9).
9) Diseases of the digestive organs (K20-K31):
a. esophageal stricture that cannot be treated (K39.3),
b. artificial esophagus (K22.9),
c. stomach and duodenal ulcer with stenosis and bleeding (K26),
d. large abdominal wall hernia (K43),
e. non-infectious enteritis and colitis accompanied by intestinal bleeding (K31.9),
f. post-surgical stomach syndrome (K31),
g. liver cirrhosis (K74),
h. cholelithiasis accompanied by jaundice (K80.3-80.5),
i. diseases of the pancreas with severe course (K85.8).
10) Diseases of the urinary system (N00-N99):
a. acute glomerulonephritis (N00-N08),
b. diseases of the urinary system accompanied by renal failure (N17-N19),
c. infections of the kidneys and urinary tract accompanied by persistent hypertension and functional impairment (N30-N39),
d. congenital nephrotic syndrome (N11),
e. hydronephrosis (N13.2).
11) Vulgar pemphigus (L10-L14).
12) Diseases of the musculoskeletal system, connective tissue (M00-M99):
a. ankylosing spondylitis (M49),
b. osteochondropathies (M90).
13) Congenital anomalies, hereditary diseases (Q00-Q49):
a. dominant hereditary disease in one parent,
b. heterozygosity for polygenic diseases in parents.
14) Conditions:
a. after the removal of a vital organ,
b. after transplantation of vital organs.
15) Physiological conditions:
a. physiological immaturity of the woman's body (16 years old and younger),
b. state of reproductive function failure in the woman (45 years old and older).
16) Severe forms of gestosis of pregnancy with multi-organ severe impairment in case of ineffective inpatient treatment (O10-O16):
The medical indications related to the woman's condition as stipulated by law are not exhaustive. In the presence of other medical indications for the pregnant woman, the issue of termination of pregnancy is resolved based on the decision of a medical commission established by the executive body of the healthcare institution.
b) Medical indications related to the pathological condition of the fetus or child:
1) dead fetus.
2) diagnosis of a developmental defect incompatible with life in the fetus.
3) multiple births of a child with similar developmental defects.
4) birth of a child with sex-linked hereditary diseases in the family.
5) congenital defects leading to irreversible limitations of vital activity:
The fact of the presence of a medical indication is confirmed by the relevant medical document certifying the woman's diagnosis:
In the presence of medical or social indications, the artificial termination of pregnancy is performed based on the justified decision of the commission with the written consent of the pregnant woman, and in the case of a minor who has not yet attained full legal capacity as prescribed by law, with the written consent of her legal representatives.
A copy of the original document confirming the medical or social indication is attached to the decision as prescribed by the legislation of the Republic of Armenia.