Intra‐cardiac lidocaine administration to induce fetal demise before late second trimester abortion, Retrospective review

Lemi Belay Tolu, Tesfaye H. Tufa, Ferid Abas, Chavi Kahn, Lauren MacAfee, Sarah Prager, Jason D. Bell

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.

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