The use of lidocaine for fetocide in late termination of pregnancy.
OBJECTIVE
To assess the use of lidocaine (1%) to induce permanent fetal cardiac asystole for fetocide in late termination of pregnancy.


METHODS
Prospective observational study.


METHODS
One tertiary referral fetal medicine unit in France.


METHODS
Fifty patients undergoing termination of pregnancy between 20 and 36 weeks of gestation for severe abnormalities or severe maternal conditions.


METHODS
Fetocide was performed by umbilical vein puncture under ultrasound guidance with injection of sufentanil (5 microg) followed by 7 to 30 mL of lidocaine (1%).


METHODS
Percentage of successful procedures to obtain permanent fetal cardiac asystole and maternal side effects.


RESULTS
The procedure was successful in 92% of cases (46/50) with complete cessation of heart activity. The mean amount of lidocaine was 15.3 (6.5) mL. In three cases, fetocide was performed by cardiocentesis and in one case lidocaine was unsuccessful and fetocide was performed with KCl. There were no maternal side effects.


CONCLUSIONS
Lidocaine is an effective drug to perform fetocide with doses below the toxic dose for the mother.
Senat
M V
MV
Department of Obstetric and Gynecology, CHI, Poissy, France.
Fischer
C
C
Bernard
J P
JP
Ville
Y
Y
D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage; D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D000577:Amides / Q000008:administration & dosage; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D004338:Drug Combinations; D005260:Female; D005313:Fetal Death / Q000139:chemically induced*; D005865:Gestational Age; D006323:Heart Arrest / Q000139:chemically induced*; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000008:administration & dosage*; D015735:Mifepristone / Q000008:administration & dosage; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D000077212:Ropivacaine; D017409:Sufentanil / Q000008:administration & dosage; D014471:Umbilical Veins
D000021:Abortifacient Agents, Steroidal; D000577:Amides; D000701:Analgesics, Opioid; D000889:Anti-Arrhythmia Agents; D004338:Drug Combinations; D015735:Mifepristone; D000077212:Ropivacaine; D008012:Lidocaine; D017409:Sufentanil