Fetal intracardiac potassium chloride injection to avoid the hopeless resuscitation of an abnormal abortus: I. Clinical issues

N. B. Isada, P. G. Pryde, M. P. Johnson, M. Hallak, W. B. Blessed, M. I. Evans

Research output: Contribution to journalArticlepeer-review

32 Scopus citations

Abstract

Objective: With the intention of preventing the attendant medical, ethical, and legal problems arising from the birth of live-born, anomalous fetuses, we initiated a program offering fetal intracardiac potassium chloride injection as an adjunctive measure in the setting of genetically indicated second-trimester abortion. Methods: A lethal fetal injection was offered to patients carrying chromosomally or structurally abnormal fetuses at 19-24 weeks' gestation who desired abortion. When the patient elected this procedure, real-time ultrasound guidance was used to inject 3-5 mL of potassium chloride (2 mEq/mL) directly into the fetal cardiac chambers, followed by observation of fetal heart activity to ascertain cessation. Labor was subsequently induced with uterotonic prostaglandins. Results: The procedure caused immediate cessation of fetal heart motion in 20 of 21 cases. There were no maternal complications. No fetuses were live-born. Conclusions: Direct fetal intracardiac potassium chloride injection effectively causes immediate fetal cardiac arrest. This approach may be adopted in cases of abortion by labor-induction methods at advanced gestations to ensure that the abortus is stillborn.

Original languageEnglish
Pages (from-to)296-299
Number of pages4
JournalObstetrics and Gynecology
Volume80
Issue number2
StatePublished - 1 Jan 1992
Externally publishedYes

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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