Sections of Maternal-Fetal Medicine and Family Planning, Department Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, 333 Cedar St, PO Box 208063, New Haven, CT 06520 USA.
J Ultrasound Med. 2014 Feb;33(2):337-41. doi: 10.7863/ultra.33.2.337.
Induction of fetal demise before second-trimester termination is performed for a number of reasons. One method for inducing fetal demise is via sonographically guided intracardiac potassium chloride (KCl) injection. We performed a retrospective cohort study to determine the efficacy and safety of intracardiac KCl injection as a method of second-trimester induced fetal demise.
We reviewed records from patients who were referred for induced fetal demise from October 2002 to October 2011. We excluded patients undergoing selective fetal reduction in multiple gestations. Procedural complications, the dose of KCl, and the number of failed procedures were determined.
Of the 192 completed procedures, 191 were successful (99.5%). The median gestational age at termination was 22 weeks (range, 15.4-24.9 weeks), and most terminations were surgical (68.0%). Major indications for termination were fetal anomalies (41.6%), unwanted pregnancy (20.8%), and aneuploidy (15.7%). The median dose of KCl was 10 mL (range, 3-40 mL). We found a significant correlation between the dose of KCl and estimated fetal weight. There was no significant correlation between the dose of KCl and body mass index or gestational age. We had 1 maternal complication of a seizure after needle placement but before KCl injection.
Intracardiac KCl injection is an effective and safe method for induced fetal demise.
在进行妊娠中期终止妊娠之前，胎儿死亡的诱导有许多原因。一种诱导胎儿死亡的方法是通过超声引导下心内氯化钾（KCl）注射。我们进行了一项回顾性队列研究，以确定心内 KCl 注射作为妊娠中期诱导胎儿死亡的方法的有效性和安全性。
我们回顾了 2002 年 10 月至 2011 年 10 月期间因诱导胎儿死亡而转诊的患者记录。我们排除了多胎妊娠中选择性胎儿减少的患者。确定了程序并发症、KCl 剂量和失败程序的数量。
在 192 例完成的程序中，191 例成功（99.5%）。终止妊娠的中位妊娠周数为 22 周（范围 15.4-24.9 周），大多数终止妊娠是手术（68.0%）。终止妊娠的主要指征是胎儿异常（41.6%）、意外怀孕（20.8%）和非整倍体（15.7%）。KCl 的中位剂量为 10 mL（范围 3-40 mL）。我们发现 KCl 剂量与估计胎儿体重之间存在显著相关性。KCl 剂量与体重指数或妊娠周数之间无显著相关性。我们有 1 例母亲在放置针头后但在注射 KCl 前发生癫痫发作的并发症。
心内 KCl 注射是诱导胎儿死亡的有效且安全的方法。
