Funic potassium chloride injection during intact dilation and evacuation.

Area of Science:

• Medical Science
• Obstetrics & Gynecology
• Fetal Medicine

Background:

• Intact Dilation and Evacuation (D&E) is a common procedure for second-trimester pregnancy termination.
• Inducing fetal demise prior to D&E can facilitate the procedure and reduce potential complications.
• Funic potassium chloride (KCl) injection is a method to achieve fetal demise.

Purpose of the Study:

• To evaluate the effectiveness and safety of funic potassium chloride (KCl) injection for inducing fetal demise during intact Dilation and Evacuation (D&E).

Main Methods:

• Retrospective review of medical records for patients undergoing intact D&E between 20 weeks 0 days and 23 weeks 6 days.
• Data collected included time to fetal asystole post-KCl injection and adverse events (hemorrhage, infection, perforation, unplanned admissions).

Main Results:

• Of 57 procedures, 32 were intact D&E. Median time to fetal asystole was 48 seconds (IQR 34-100).
• Asystole occurred in under four minutes in all but one case.
• No adverse events were reported related to funic KCl injection or intact D&E procedures.

Conclusions:

• Funic KCl injection is a feasible and effective method for inducing fetal asystole during intact D&E.
• The procedure is generally rapid, with asystole occurring within minutes.
• No complications were observed, indicating a favorable safety profile.