Intra‐cardiac lidocaine administration to induce fetal demise before late second‐trimester abortion: Retrospective review. Issue 1 (11th November 2020)

• Record Type: Journal Article
• Authors: Tolu, Lemi Belay; Tufa, Tesfaye H.; Abas, Ferid; Kahn, Chavi; MacAfee, Lauren; Prager, Sarah; Bell, Jason D.
• Is Part Of: International journal of gynaecology and obstetrics. Volume 153:Issue 1(2021)
• Page Start: 125
• Page End: 129
• Publication Date: 2020-11-11
• Subjects: Ethiopia -- Fetal demise -- Intra‐cardiac lidocaine -- Late abortion -- Lidocaine -- Medication abortion; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.13419
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To determine the efficacy and safety of intra‐cardiac lidocaine administration to induce fetal demise before second‐trimester medication abortion in a teaching hospital in Addis Ababa, Ethiopia. Methods: We performed a retrospective chart review to collect selected sociodemographic and clinical information. All patients who received fetal intra‐cardiac lidocaine between January 1, 2019 and April 30, 2019 were included in the study. Fetal demise was considered successful if achieved within 24 hours after fetal intra‐cardiac lidocaine administration. We analyzed the data using SPSS version 20. We used frequency tables to describe the data and performed a multivariable analysis to determine associations between variables. Results: A total of 80 fetuses were given intra‐cardiac lidocaine.The mean gestational age was 23 +1 weeks (range 21 +0 –27 +5 weeks). Twenty‐four hours after lidocaine administration 76 (95%) pregnancies showed negative fetal cardiac activity. Fetuses at gestational ages of 21–23 +6 weeks were five times more likely to have negative cardiac activity compared with those with gestational ages between 24 and 28 weeks ( P =0.001). Two women developed nausea, vomiting, and a metallic taste, but no serious adverse events were reported. Conclusions: Intra‐cardiac lidocaine is effective at inducing fetal demise before late second‐trimester medication abortion with no associated serious adverse events or complications. Abstract : Intra‐cardiac lidocaine is effective at inducing fetal demise before second‐trimester medication abortion with no serious adverse events.