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Feasibility of intra-amniotic digoxin administration by obstetrics and gynecology trainees to induce fetal demise prior to medical abortion beyond 20 weeks

BACKGROUND: Transient fetal survival is one issue that providers may face while managing late second-trimester abortion. Induction of fetal demise using digoxin and other means has been widely performed by maternal–fetal medicine and family planning subspecialists worldwide. However, there are no da...

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Autores principales: Tufa, Tesfaye Hurissa, Lavelanet, Antonella Francheska, Belay, Lemi, Seboka, Berhanu, Bell, Jason
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7569366/
https://www.ncbi.nlm.nih.gov/pubmed/32241827
http://dx.doi.org/10.1136/bmjsrh-2019-200396
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author Tufa, Tesfaye Hurissa
Lavelanet, Antonella Francheska
Belay, Lemi
Seboka, Berhanu
Bell, Jason
author_facet Tufa, Tesfaye Hurissa
Lavelanet, Antonella Francheska
Belay, Lemi
Seboka, Berhanu
Bell, Jason
author_sort Tufa, Tesfaye Hurissa
collection PubMed
description BACKGROUND: Transient fetal survival is one issue that providers may face while managing late second-trimester abortion. Induction of fetal demise using digoxin and other means has been widely performed by maternal–fetal medicine and family planning subspecialists worldwide. However, there are no data available in Ethiopia as regards preventing transient fetal survival in late second-trimester medical termination of pregnancy. OBJECTIVE: The objective of the study was to document the feasibility of intra-amniotic digoxin administration for inducing fetal demise prior to medical abortion beyond 20 weeks of gestational age. Additionally, we aimed to demonstrate that this skill could be transferred to obstetrics and gynaecology residents at St Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. METHODS: A retrospective cross-sectional study design was conducted to document the feasibility, safety and effectiveness of intra-amniotic digoxin. A structured questionnaire was used to collect selected sociodemographic data and clinical characteristics. Data were entered and analysed using SPSS statistical package version 20. RESULTS: During the study period, 49 women received intra-amniotic digoxin. The success rate of intra-amniotic digoxin in this study was 95.9%. Thirty-seven (75.5%) procedures were performed by obstetrics and gynaecology residents and 12 (24.5%) were performed by family planning faculties. There were two out of hospital expulsions with no signs of life, and no other serious maternal complications were observed. CONCLUSION: It is feasible for obstetrics and gynaecology trainees in Ethiopia to learn how to safely administer intra-amniotic digoxin to induce fetal demise for induced medical terminations.
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spelling pubmed-75693662020-10-20 Feasibility of intra-amniotic digoxin administration by obstetrics and gynecology trainees to induce fetal demise prior to medical abortion beyond 20 weeks Tufa, Tesfaye Hurissa Lavelanet, Antonella Francheska Belay, Lemi Seboka, Berhanu Bell, Jason BMJ Sex Reprod Health Original Research BACKGROUND: Transient fetal survival is one issue that providers may face while managing late second-trimester abortion. Induction of fetal demise using digoxin and other means has been widely performed by maternal–fetal medicine and family planning subspecialists worldwide. However, there are no data available in Ethiopia as regards preventing transient fetal survival in late second-trimester medical termination of pregnancy. OBJECTIVE: The objective of the study was to document the feasibility of intra-amniotic digoxin administration for inducing fetal demise prior to medical abortion beyond 20 weeks of gestational age. Additionally, we aimed to demonstrate that this skill could be transferred to obstetrics and gynaecology residents at St Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. METHODS: A retrospective cross-sectional study design was conducted to document the feasibility, safety and effectiveness of intra-amniotic digoxin. A structured questionnaire was used to collect selected sociodemographic data and clinical characteristics. Data were entered and analysed using SPSS statistical package version 20. RESULTS: During the study period, 49 women received intra-amniotic digoxin. The success rate of intra-amniotic digoxin in this study was 95.9%. Thirty-seven (75.5%) procedures were performed by obstetrics and gynaecology residents and 12 (24.5%) were performed by family planning faculties. There were two out of hospital expulsions with no signs of life, and no other serious maternal complications were observed. CONCLUSION: It is feasible for obstetrics and gynaecology trainees in Ethiopia to learn how to safely administer intra-amniotic digoxin to induce fetal demise for induced medical terminations. BMJ Publishing Group 2020-10 2020-04-02 /pmc/articles/PMC7569366/ /pubmed/32241827 http://dx.doi.org/10.1136/bmjsrh-2019-200396 Text en ©World Health Organization 2020. Licensee BMJ. This is an open access article distributed under the terms of the Creative Commons Attribution-Non commercial IGO License (CC BY-NC 3.0 IGO), which permits use, distribution, and reproduction for non-commercial purposes in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.
spellingShingle Original Research
Tufa, Tesfaye Hurissa
Lavelanet, Antonella Francheska
Belay, Lemi
Seboka, Berhanu
Bell, Jason
Feasibility of intra-amniotic digoxin administration by obstetrics and gynecology trainees to induce fetal demise prior to medical abortion beyond 20 weeks
title Feasibility of intra-amniotic digoxin administration by obstetrics and gynecology trainees to induce fetal demise prior to medical abortion beyond 20 weeks
title_full Feasibility of intra-amniotic digoxin administration by obstetrics and gynecology trainees to induce fetal demise prior to medical abortion beyond 20 weeks
title_fullStr Feasibility of intra-amniotic digoxin administration by obstetrics and gynecology trainees to induce fetal demise prior to medical abortion beyond 20 weeks
title_full_unstemmed Feasibility of intra-amniotic digoxin administration by obstetrics and gynecology trainees to induce fetal demise prior to medical abortion beyond 20 weeks
title_short Feasibility of intra-amniotic digoxin administration by obstetrics and gynecology trainees to induce fetal demise prior to medical abortion beyond 20 weeks
title_sort feasibility of intra-amniotic digoxin administration by obstetrics and gynecology trainees to induce fetal demise prior to medical abortion beyond 20 weeks
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7569366/
https://www.ncbi.nlm.nih.gov/pubmed/32241827
http://dx.doi.org/10.1136/bmjsrh-2019-200396
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