Safety, effectiveness, and feasibility of funic potassium chloride injection to induce fetal demise prior to dilation and evacuation
Awarded 2014
Small Research Grants
Siripanth Nippita, MD, MS
Beth Israel Deaconess Medical Center

Objective: To describe the effectiveness of funic potassium chloride (KCl) injection for fetal demise at the time of intact dilation and evacuation, and compare outcomes for patients undergoing intact versus standard dilation and evacuation. Methods: We reviewed medical records of patients who underwent dilation and evacuation at 20 weeks’ gestation or greater from February 2016 through August 2017. We abstracted demographic information, total procedure time as recorded by the circulating nurse in the operating room, estimated blood loss, and information on complications for at least six months following each procedure. Continuous data are presented as median (interquartile range) and were compared with the Mann-Whitney U test. We compared proportions with Fisher’s exact test. We performed all analyses using STATA 15.0. Results: There were 57 dilation and evacuation procedures during the study period; 32 (56%) were intact. Among patients undergoing intact dilation and evacuation, the median time from KCl injection to fetal asystole was 48 seconds (34-100). Mean procedure times were similar for intact [34.5 minutes (30.5-42.5)] and standard [36 minutes (33-42.5)] dilation and evacuations (p=0.56). The incidence of hemorrhage was rare and similar in both groups (p=0.99). Conclusion: Funic KCl injection quickly and reliably causes fetal asystole. Outcomes are similar for patients undergoing intact and standard dilation and evacuation.