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Feticidal digoxin injection before dilation and evacuation abortion

Evidence and ethics
      Feticidal injection of digoxin before dilation and evacuation (D&E) abortion has become common in recent years and is now a standard policy at some abortion clinics. The procedure entails amniocentesis and administration of digoxin into the amniotic fluid or fetus before uterine evacuation. Two new reports in this issue of the journal present conflicting views about its safety [
      • Steward R.L.
      • Melamed A.
      • Kim R.
      • Nucatola D
      • Gatter M.
      Infection and extramural delivery with use of digoxin as a feticidal agent.
      ,
      • Dean G.
      • Colarossi L.
      • Lunde B.
      • Jacobs A.R.
      • Porsch L.
      • Paul M.E.
      Safety of digoxin for fetal demise before second-trimester abortion by dilation and evacuation.
      ].
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      References

        • Steward R.L.
        • Melamed A.
        • Kim R.
        • Nucatola D
        • Gatter M.
        Infection and extramural delivery with use of digoxin as a feticidal agent.
        Contraception. 2012; 85: 150-154
        • Dean G.
        • Colarossi L.
        • Lunde B.
        • Jacobs A.R.
        • Porsch L.
        • Paul M.E.
        Safety of digoxin for fetal demise before second-trimester abortion by dilation and evacuation.
        Contraception. 2012; 85: 144-149
        • Jackson R.A.
        • Teplin V.L.
        • Drey E.A.
        • Thomas L.J.
        • Darney P.D.
        Digoxin to facilitate late second-trimester abortion: a randomized, masked, placebo-controlled trial.
        Obstet Gynecol. 2001; 97: 471-476
        • Nucatola D.
        • Roth N.
        • Gatter M.
        A randomized pilot study on the effectiveness and side effect profiles of two doses of digoxin as fetocide when administered intraamniotically or intrafetally prior to second-trimester surgical abortion.
        Contraception. 2010; 81: 67-74
        • Borgatta L.
        • Betstadt S.J.
        • Reed A.
        • Feng K.T.
        Relationship of intraamniotic digoxin to fetal demise.
        Contraception. 2010; 81: 328-330
        • Molaei M.
        • Jones H.E.
        • Weiselberg T.
        • McManama M.
        • Bassell J.
        • Westhoff C.L.
        Effectiveness and safety of digoxin to induce fetal demise prior to second-trimester abortion.
        Contraception. 2008; 77: 223-225
        • Drey E.A.
        • Thomas L.J.
        • Benowitz N.L.
        • Goldschlager N.
        • Darney P.D.
        Safety of intra-amniotic digoxin administration before late second-trimester abortion by dilation and evacuation.
        Am J Obstet Gynecol. 2000; 182: 1063-1066
        • Hern W.M.
        Laminaria, induced fetal demise and misoprostol in late abortion.
        Int J Gynaecol Obstet. 2001; 75: 279-286
        • Hern W.M.
        • Zen C.
        • Ferguson K.A.
        • Hart V.
        • Haseman M.V.
        Outpatient abortion for fetal anomaly and fetal death from 15–34 menstrual weeks' gestation: techniques and clinical management.
        Obstet Gynecol. 1993; 81: 301-306
        • Grimes D.A.
        • Schulz K.F.
        Descriptive studies: what they can and cannot do.
        Lancet. 2002; 359: 145-149
        • Diedrich J.
        • Drey E.
        Induction of fetal demise before abortion.
        Contraception. 2010; 81: 462-473
        • Lee S.J.
        • Ralston H.J.
        • Drey E.A.
        • Partridge J.C.
        • Rosen M.A.
        Fetal pain: a systematic multidisciplinary review of the evidence.
        JAMA. 2005; 294: 947-954
        • Hammond C.
        Recent advances in second-trimester abortion: an evidence-based review.
        Am J Obstet Gynecol. 2009; 200: 347-356
        • Annas G.J.
        Partial-birth abortion, Congress, and the Constitution.
        N Engl J Med. 1998; 339: 279-283
        • Haddad L.
        • Yanow S.
        • Delli-Bovi L.
        • Cosby K.
        • Weitz T.A.
        Changes in abortion provider practices in response to the Partial-Birth Abortion Ban Act of 2003.
        Contraception. 2009; 79: 379-384
        • Grimes D.A.
        How can we translate good science into good perinatal care?.
        Birth. 1986; 13: 83-90
        • Hiatt H.H.
        Protecting the medical commons: who is responsible?.
        N Engl J Med. 1975; 293: 235-241
        • Relman A.S.
        On controversy in medicine.
        Pharos Alpha Omega Alpha Honor Med Soc. 1978; 41: 18-22
        • Grimes D.A.
        Technology follies. The uncritical acceptance of medical innovation.
        JAMA. 1993; 269: 3030-3033
        • Sackett D.L.
        • Straus S.E.
        • Richardson W.S.
        • Rosenberg W.
        • Haynes R.B.
        Evidence-based medicine. How to practice and teach EBM.
        2nd ed. Churchill Livingstone, Edinburgh2000
        • Ergina P.L.
        • Cook J.A.
        • Blazeby J.M.
        • et al.
        Challenges in evaluating surgical innovation.
        Lancet. 2009; 374: 1097-1104