Abstract
Objective
To describe effectiveness of funic potassium chloride (KCl) injection for fetal demise
during intact dilation and evacuation (D&E).
Study design
We abstracted medical records of patients who underwent standard or intact D&E to
identify those who had intact D&E from 20 weeks 0 days through 23 weeks 6 days from
February 2016 to August 2017 at one academic center. We extracted data on time to
asystole following KCl injection, as well as incidents including hemorrhage, infection,
uterine perforation, and unplanned admissions for up to 6 months following each procedure.
Results
Of 57 procedures, 32 (56%) were intact. Median time from KCl injection to fetal asystole
was 48 seconds (interquartile range [IQR] 34-100). Median time to asystole at weeks
20 and 21 (46 seconds [IQR 34-60 seconds]) did not differ significantly from weeks
22 and 23 (85 seconds [IQR 34-200 seconds]), p = 0.15. Asystole occurred in less than four minutes in all cases but one. No adverse
events occurred with either the funic KCl injections or the intact D&E procedures.
Conclusion
Funic KCl injection for intact D&E usually causes fetal asystole in less than 4 minutes.
Implications
Funic KCl injection under direct visualization is a feasible method to induce fetal
asystole at the time of intact dilation and evacuation.
Keywords
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Article info
Publication history
Published online: April 04, 2021
Accepted:
March 30,
2021
Received in revised form:
March 26,
2021
Received:
December 5,
2018
Identification
Copyright
Published by Elsevier Inc.
