Cardiac Tamponade: An Alternative Procedure for Late Feticide

Chen, Chia‐Hsiang; Hsieh, Hsin-Chin; Tsai, Horng‐Der; Chen, Tze-Ho; Chen, Ming

doi:10.1016/s1028-4559(09)60278-3

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…Concerning the procedure, our results show a direct correlation between the dose of KCl and advancing gestation at the time of performance of feticide. Various methods of feticide with differing success rates are described, including intra-umbilical lidocaine and KCl, [8][9][10][11][12][13] intracardiac KCl, 9 cardiac tamponade with normal saline 10 and aspiration of blood from the fetal heart. 11 One group 5 also uses intra-umbilical sufantenil for fetal analgesia before administering the lethal drug.…”

Section: Discussionmentioning

confidence: 99%

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Late termination of pregnancy by intracardiac potassium chloride injection: 5 years' experience at a tertiary referral centre

Govender

Moodley

2012

S Afr Med J

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Objectives. To report our experience with intracardiac potassium chloride (KCl) injection as a method of feticide for severe congenital abnormalities beyond 24 weeks' gestation. Method. A retrospective chart review. Patient demographics and types of fetal anomalies were analysed according to the groups that accepted or declined late termination of pregnancy (LTOP, ≥24 weeks) for severe congenital abnormalities. Results. Of 3 896 women referred to the Fetal Medicine Unit at Inkosi Albert Luthuli Central Hospital, KwaZulu-Natal, 2 209 (56.7%) were at ≥24 weeks' gestation at their first visit. LTOP for severe congenital abnormalities was offered to 253 (11.5%), of whom 191 (75.5%) accepted. Differences in maternal age, parity, race and religion were not statistically significant. The type of fetal abnormalities and gestational age at diagnosis influenced the decision-making process in >80% of the women. The most frequent indications for LTOP were brain and spinal abnormalities (53.0%), and aneuploidy (20.6%). Feticide by ultrasound-guided intracardiac KCl injection was performed in 138/191 cases (72.2%); 53 women who accepted LTOP did not undergo feticide for a variety of reasons. The mean interval between diagnosis and performance of feticide was 10 days (range 0 -42 days). Fetal asystole was achieved in all cases within 2 minutes by a single-needle injection of intracardiac KCl; the mean duration of the procedure was 12 minutes (range 6 -25 minutes). There were no maternal complications, and stillbirths occurred in all cases. Conclusion. Feticide by ultrasound-guided intracardiac KCl injection was an acceptable, safe and effective method for LTOP. Further studies are needed to determine the minimum dosage of KCl required to achieve the desired effect.

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Section: Discussionmentioning

confidence: 99%

“…Several methods of feticide have been described, [6][7][8][9][10][11] including intracardiac or intraumbilical potassium chloride or lignocaine injection to induce cardiac asystole. For women who choose to terminate pregnancy with an abnormal fetus at an advanced gestation, the method used must be safe and effective.…”

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confidence: 99%

Late termination of pregnancy by intracardiac potassium chloride injection: 5 years' experience at a tertiary referral centre

Govender

Moodley

2012

S Afr Med J

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“…Because both ART and monozygotic twins are risk factors of BWS, prenatal screening of BWS by MS-MLPA in these case groups may be helpful for the early detection of disease. Nevertheless, since common complications in pregnancies with BWS fetuses (e.g., gestational hypertension, pre-eclampsia, gestational diabetes mellitus, vaginal bleeding) usually start after the GA of 22 weeks [ 15 ], screening of BWS at an early gestation when pregnancy complications yet occur may cause excess anxiety although BWS is extremely rare, and late TOP remains a feasible and legal rescuing option in Taiwan [ 72 ].…”

Section: Discussionmentioning

confidence: 99%

Proposal for Practical Approach in Prenatal Diagnosis of Beckwith–Wiedemann Syndrome and Review of the Literature

Chen

et al. 2022

Diagnostics

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Background: Beckwith–Wiedemann syndrome (BWS) is a phenotypically and genetically heterogeneous disorder associated with epigenetic/genetic aberrations on chromosome 11p15.4p15.5. There is no consensus criterion for prenatal diagnosis of BWS. Methods: Three BWS patients with their clinical histories, prenatal ultrasonographic features, and results of molecular diagnosis were presented. Likewise, by incorporating the findings of our cases and literature review, the phenotypic spectrum and genotype–phenotype correlations of fetal BWS were summarized, and a practical approach in prenatal diagnosis of BWS was proposed. Results: A total of 166 BWS cases with prenatal features were included for analysis. Common fetal features include abdominal wall defects (42.8%), polyhydramnios (33.1%), and macrosomia (32.5%). Molecular pathologies include methylation changes in imprinting control region 1 and 2 (ICR1 and ICR2), paternal uniparental disomy of chromosome 11p15.5, copy number change involving 11p15, etc. Some genotype–phenotype correlations were observed. However, the broad phenotypic spectrum but limited features manifested by affected fetuses rendering ultrasonographic diagnosis not easy. Conclusions: Molecular tests are used for prenatal diagnosis of BWS suspected by ultrasonography. Methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) is recommended as the first-line molecular tool because it simultaneously detects ICR1/ICR2 methylation statuses and copy numbers that solve the majority of clinical cases in the prenatal scenario.

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“…Not only does this present additional obstetrical challenges, but it raises the possibility of a live birth. In order to forestall this latter eventuality, feticide has become an increasingly common practice in obstetrical centers around the globe, a concomitant of previously accepted prenatal screening practices (Bijma et al 2007; Graham et al 2008; 2009; Dommergues et al 2003; Chen et al 2009). …”

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confidence: 99%

Human Non-persons, Feticide, and the Erosion of Dignity

Pullman

2010

Bioethical Inquiry

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Feticide, the practice of terminating the life of an otherwise viable fetus in utero, has become an increasingly common practice in obstetric centres around the globe, a concomitant of antenatal screening technologies. This paper examines this expanding practice in light of the concept of human dignity. Although it is assumed from the outset that even viable human fetuses are not persons and as such do not enjoy full membership in the moral community, it is argued that the fact that these are nevertheless human fetuses affords them prima facie moral status. Thus even those who accept a liberal position with regard to therapeutic abortion, should be concerned about these more recent developments. Indeed, how we treat viable human fetuses has implications for our prospective treatment of other human non-persons and could undermine the common human dignity we all share.

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Cardiac Tamponade: An Alternative Procedure for Late Feticide

Cited by 5 publications

References 16 publications

Late termination of pregnancy by intracardiac potassium chloride injection: 5 years' experience at a tertiary referral centre

Late termination of pregnancy by intracardiac potassium chloride injection: 5 years' experience at a tertiary referral centre

Proposal for Practical Approach in Prenatal Diagnosis of Beckwith–Wiedemann Syndrome and Review of the Literature

Human Non-persons, Feticide, and the Erosion of Dignity

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