Wednesday, December 21, 2011

Study examined whether feticide improves "surgical outcomes" in dismemberment abortions

From a study abstract:

Objective: To determine whether potassium chloride (KCl)-induced feticide prior to termination by dilation and evacuation (D&E) improves surgical outcome.

Methods: We conducted a retrospective study of women who underwent second-trimester (13 0/7 to 23 6/7 weeks) D&E at an urban university-based hospital between January 2000 and July 2010. Women were divided into 3 cohorts: (1) D&E for termination of pregnancy after feticide, (2) D&E without feticide, and (3) D&E for spontaneous pregnancy loss. We compared maternal characteristics, various perioperative variables, and surgical outcomes for all 3 groups. Anesthesia time was used as a surrogate for operative time in the primary outcome.

Results: We analyzed 128 pregnancies (group 1: n = 23, group 2: n = 53, group 3: n = 52). Baseline maternal characteristics did not differ among the 3 groups. Anesthesia time was longest in the termination with KCl group (group 1: 116.9 min vs. group 2: 94.5 min and group 3: 90.3 min, p = 0.004), however, the effect was mitigated after controlling for fetal size (p = 0.176). There was no difference in blood loss (p = 0.968). Complications were uncommon, however, cervical lacerations were more common in the termination with KCl group (2 vs. 0 and 0, p = 0.010).

Conclusion: Presurgical feticide with KCl was not associated with shorter anesthesia time. The decision to perform feticide should be based on other considerations, such as patient preference.

So what they're trying to do is determine whether injecting a fetus with potassium chloride (usually in the heart) speeds up the abortion. Because goodness knows, time is money!

The researchers decided to measure the time the anesthetic was operative (I'm assuming. I doubt it takes anesthesia 117 minutes to kick in, judging from my experience in childbirth).

It appears that injecting fetuses with KCl does not speed up abortion.

I would say "thank goodness for small mercies" except that it's debatable whether death by dismemberment is a less painful and more dignified death than death by an injection of potassium chloride to the heart. Would you rather die of a painful heart attack or of getting your head crushed?

Fetal Intracardiac Potassium Chloride Injection to Expedite Second-Trimester Dilation and Evacuation
Sareena Singha, Neil S. Seligmanb, Brittany Jacksona, Vincenzo Berghellaa
aDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pa., and
bDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, N.Y., USA
Fetal Diagn Ther (DOI: 10.1159/000333815)