title: Fetal intracardiac potassium chloride injection to expedite second-trimester dilation and evacuation.
abstract: OBJECTIVE
  To determine whether potassium chloride (KCl)-induced feticide prior to termination by dilation and evacuation (D&E) improves surgical outcome.
  
  
  METHODS
  We conducted a retrospective study of women who underwent second-trimester (13 0/7 to 23 6/7 weeks) D&E at an urban university-based hospital between January 2000 and July 2010. Women were divided into 3 cohorts: (1) D&E for termination of pregnancy after feticide, (2) D&E without feticide, and (3) D&E for spontaneous pregnancy loss. We compared maternal characteristics, various perioperative variables, and surgical outcomes for all 3 groups. Anesthesia time was used as a surrogate for operative time in the primary outcome.
  
  
  RESULTS
  We analyzed 128 pregnancies (group 1: n = 23, group 2: n = 53, group 3: n = 52). Baseline maternal characteristics did not differ among the 3 groups. Anesthesia time was longest in the termination with KCl group (group 1: 116.9 min vs. group 2: 94.5 min and group 3: 90.3 min, p = 0.004), however, the effect was mitigated after controlling for fetal size (p = 0.176). There was no difference in blood loss (p = 0.968). Complications were uncommon, however, cervical lacerations were more common in the termination with KCl group (2 vs. 0 and 0, p = 0.010).
  
  
  CONCLUSIONS
  Presurgical feticide with KCl was not associated with shorter anesthesia time. The decision to perform feticide should be based on other considerations, such as patient preference.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19107, USA. singh.sareena@gmail.com
authors.forename: Sareena
authors.initials: S
authors.lastname: Singh
authors.forename: Neil S
authors.initials: NS
authors.lastname: Seligman
authors.forename: Brittany
authors.initials: B
authors.lastname: Jackson
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Berghella
mesh_terms: D000028:Abortion, Induced / Q000379:methods*; D005260:Female; D005318:Fetal Heart; D006801:Humans; D007267:Injections; D011189:Potassium Chloride / Q000008:administration & dosage*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D011189:Potassium Chloride