Effect of causing fetal cardiac asystole on second-trimester abortion

Objective: To compare second-trimester abortions with prostaglandin (PG) E- 2, with and without pretreatment-induced fetal death. Methods: A retrospective chart review of all vaginal PG E-2-induced abortio ns at Westchester Medical Center between January 1996 and April 1998 was do ne. Only women who sought terminations between 18 and 24 weeks' gestation b y prostaglandin induction were included. These abortions were predominantly secondary to fetal structural and chromosomal anomalies. The study populat ion was subdivided into groups based on the use of pretreatment cardiac pun cture,vith potassium chloride. The groups were compared for maternal, fetal , and procedural characteristics, The chi(2) test, Student t test, and Wilc oxon rank-sum test were used for analysis. Results: There were no differences between the cardiac puncture and control groups when compared for various maternal and procedural characteristics, fetal weight, and the need for curettage for retained products of conceptio n. However, the required median doses of PG E-2 and the initiation to expul sion interval were significantly lower in the cardiac puncture group compar ed with the control group (2.0 doses compared with 3.0 doses, P < .001; 570 minutes compared with 890 minutes, P = .006). Conclusion: Pretreatment-induced fetal death significantly reduced the inte rval to expulsion and doses of PG E-2 required for late second-trimester ab ortion. (C) 1999 by The American College of Obstetricians and Gynecologists .