Relationship of intraamniotic digoxin to fetal demise.
BACKGROUND
Induced fetal demise by intraamniotic injection of digoxin is an alternative to methods using intracardiac or umbilical vein injection. This study was designed to evaluate the effectiveness of intraamniotic injection and the timing of fetal demise after injection.


METHODS
Twenty-two women had ultrasonic fetal cardiac assessments 1, 2, 4 and 20 to 24 h after intraamniotic injection of 1.5 mg digoxin.


RESULTS
Fetal cardiac activity was absent in 21/21 women assessed at least 20 h after injection. One woman had agonal (40 bpm) fetal cardiac activity at 14 h. Most women had fetal cardiac activity 4 h after injection. Signs of toxicity were not seen.


CONCLUSIONS
Intraamniotic injection of digoxin 1.5 mg is effective at causing fetal demise by 20 to 24 h. However, for most women, fetal demise is not obtained within 4 h.
Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA 02118, USA. lynn.borgatta@bmc.org
Lynn
L
Borgatta
Sarah J
SJ
Betstadt
Ann
A
Reed
Kui-tzu
KT
Feng
D037881:Aborted Fetus / Q000187:drug effects*; D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage* / Q000009:adverse effects; D000028:Abortion, Induced / Q000379:methods*; D000653:Amniotic Fluid; D004077:Digoxin / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006340:Heart Rate, Fetal / Q000187:drug effects; D006801:Humans; D007267:Injections; D011247:Pregnancy
D000020:Abortifacient Agents, Nonsteroidal; D004077:Digoxin