Introduction We sought to assess the efficacy of transabdominal intrafetal lidocaine to achieve fetal demise before pregnancy termination. Methods This study was a retrospective cohort analysis of patients undergoing transabdominal intrafetal lidocaine injections prior to abortion procedures after 24 weeks from January 2018 to June 2020 at DuPont Clinic, an outpatient obstetrics and gynaecology clinic in Washington, DC, USA. We recorded data on maternal factors, gestational age, time of injection and fetal asystole, and injection dose and location. We defined successful intrafetal lidocaine injection as asystole achieved prior to the patient leaving the clinic. Results We performed injections in 338 fetuses in 335 patients, with a median gestational age of 27 weeks and 6 days (range 24–32 weeks). Lidocaine dose was 200–240 mg in 310 cases (91.7%) and 400–480 mg in 27 cases (8.0%) without difference in success (p&gt;0.05). Lidocaine successfully induced fetal demise with one injection in 331 cases (97.9%). A second injection was required to induce demise for five fetuses (1.5%). Intracardiac injection was successful in 280 of 285 cases (98.3%), with asystole confirmed within 1 min in 75% of cases. Intrathoracic injection caused asystole in 45 of 47 cases (95.7%), with asystole confirmed within 2 min in 75% of cases. Success was not significantly associated with gestational age, body mass index or parity (p&gt;0.05). One patient reported lidocaine-related side effects (0.3%). Conclusions Intrafetal lidocaine is a safe and effective method of inducing fetal demise. Intracardiac injection achieves fetal asystole almost immediately. Intrathoracic injection is also highly effective.

Matthew F Reeves

Caroline N Goldfarb

Stacey Leigh Rubin

Jessica L Kuperstock

Leah DiBianco

Andrea Picciotto

BMJ Sexual & Reproductive Health

BMJ SEXUAL & REPRODUCTIVE HEALTH 是一本多专业期刊，旨在促进全球性与生殖健康和福祉，以及最佳避孕实践。它发表研究、辩论和评论，为政策和实践提供信息，并认识到专业患者伙伴关系的重要性。

BMJ Sexual and Reproductive Health is a multidisciplinary journal aimed at promoting global sexual and reproductive health and well-being, as well as best practices in contraception. It publishes research, debates, and reviews to inform policy and practice, recognizing the importance of professional-patient partnerships.

BMJ Sexual and Reproductive Health 是一本多学科期刊，旨在促进全球性与生殖健康及福祉，并推广最佳避孕实践。期刊发表研究、辩论和评论，为政策和实践提供信息，同时强调专业与患者之间的合作关系的重要性。

Category	Quartile
医学	3
医学, 家庭研究	3
医学, 妇产科学	3
医学, 社会科学生物医学	3

Transabdominal lidocaine to induce fetal demise: a cohort study

ivySCI AI Smartly Parses PDF, Answers Researchers' Questions, and Helps You Understand Papers in Seconds

Journal Info

Category	Quartile
SOCIAL SCIENCES, BIOMEDICAL	1