Sium Abraham Fessehaye, Tufa Tesfaye H, Grentzer Jaclyn M, Prager Sarah
St. Paul's Hospital Millennium Medical College, Department of Obstetrics and Gynecology, St. Paul's Hospital Addis Ababa, Addis Ababa, Ethiopia.
Family Planning Division, Department of Obstetrics and Gynecology, UW Medicine, Seattle, United States.
Contracept X. 2022 Jul 31;4:100082. doi: 10.1016/j.conx.2022.100082. eCollection 2022.
Current literature recommends inducing fetal demise prior to second trimester medication abortion beyond 20 weeks of gestation. There is inadequate literature regarding the practice and effectiveness of this procedure in low-income countries, such as Ethiopia. This study aimed at documenting the effectiveness of intra-cardiac lidocaine and intra-amniotic digoxin at inducing fetal demise before second trimester medication abortion in an Ethiopian setting.
This is a retrospective chart review conducted at St. Paul's Hospital Millennium Medical College, in Ethiopia. A total of 65 cases of feticide administration before 2 trimester medication abortion between 20 and 28 weeks of gestation (From April 1, 2021 to September 30, 2021) were reviewed. The primary outcome was cessation of fetal cardiac activity the day after the first feticide injection. Data were extracted by reviewing maternal charts using a data extraction tool prepared in English. Data were analyzed using SPSS version 23. Simple descriptive statistics were used to analyze baseline characteristics and fetal demise outcomes. Results were presented in percentages and frequencies.
More than three quarters of the feticide injections were with intra-amniotic digoxin, while the rest (24.6%, 16/65) were with intra-cardiac lidocaine. Injection of digoxin or lidocaine was effective at inducing fetal demise the day after administration in 92.3% (60/65) of the cases. Intracardiac lidocaine administration was 100% (16/16) effective at inducing fetal demise within the day after the injection while the effectiveness of digoxin within the same period was 89.8%.
In this study, both intra-amniotic digoxin and intra-cardiac lidocaine were effective at inducing fetal demise, which is in support of findings from similar previous studies.
In an Ethiopian setting, both intra-amniotic digoxin and intra-cardiac lidocaine injections are effective at inducing fetal demise before second trimester abortion beyond 20 weeks of gestation within the next day after feticide administration.
当前文献建议在妊娠20周后进行中期药物流产前诱导胎儿死亡。在埃塞俄比亚等低收入国家，关于这一程序的实践和有效性的文献不足。本研究旨在记录在埃塞俄比亚环境中，心内注射利多卡因和羊膜腔内注射地高辛在中期药物流产前诱导胎儿死亡的有效性。
这是在埃塞俄比亚圣保罗医院千禧医学院进行的一项回顾性病历审查。共审查了2021年4月1日至2021年9月30日期间65例妊娠20至28周中期药物流产前进行杀胎药物给药的病例。主要结局是首次注射杀胎药物后第二天胎儿心脏活动停止。通过使用用英语编写的数据提取工具审查产妇病历来提取数据。使用SPSS 23版进行数据分析。使用简单描述性统计分析基线特征和胎儿死亡结局。结果以百分比和频率表示。
超过四分之三的杀胎药物注射使用羊膜腔内注射地高辛，其余（24.6%，16/65）使用心内注射利多卡因。在92.3%（60/65）的病例中，注射地高辛或利多卡因在给药后第二天有效诱导胎儿死亡。心内注射利多卡因在注射后一天内诱导胎儿死亡的有效率为100%（16/16），而同期地高辛的有效率为89.8%。
在本研究中，羊膜腔内注射地高辛和心内注射利多卡因均能有效诱导胎儿死亡，这支持了以往类似研究的结果。
在埃塞俄比亚环境中，羊膜腔内注射地高辛和心内注射利多卡因在杀胎药物给药后的第二天内，对于妊娠20周后中期流产前诱导胎儿死亡均有效。
