INDUCTION OF FETAL DEMISE IN ADVANCED PREGNANCY TERMINATIONS - REPORTON A FUNIC POTASSIUM-CHLORIDE PROTOCOL

Advanced pregnancy termination with uterotonic agents with their inher ent risk for occurrence of a live birth and surgical evacuation of a f etus perceived to be vigorous can both be sources of emotional anguish for women. They argue for offering women an option for induction of f etal demise prior to uterine evacuation. We report on our experience w ith 60 pregnancies in which lethal fetal administration of potassium c hloride was performed prior to evacuation of the uterus. We describe a double-bolus technique for funic intravascular injection of potassium chloride to arrest the fetal heart. There were no maternal complicati ons and the procedure was successful in 86.7% (n = 52) of the cases; o f the remaining 8 cases, 7 had demise induced by direct fetal cardiac injection, and a live birth occurred in 1 case.