Effectiveness of intra-cardiac lidocaine and intra-amniotic digoxin at inducing fetal demise before second trimester abortion past 20 weeks at a tertiary Hospital in Ethiopia: A retrospective review

Sium, Abraham Fessehaye; Tufa, Tesfaye H.; Grentzer, Jaclyn M.; Prager, Sarah

doi:10.1016/j.conx.2022.100082

Cited by 1 publication

(1 citation statement)

References 15 publications

(17 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the USA, D&E is the norm, whereas in much of Europe medication abortion is used 13 . In Ethiopia, medication abortion is the most common method for later abortions, 14 though second‐trimester D&E is provided as an effective method of abortion 15 …”

Section: Discussionmentioning

confidence: 99%

Second‐trimester dilatation and evacuation: Comparison of routine intraoperative ultrasonography versus problem‐based intraoperative ultrasonography in reducing procedure‐related complications: A pre‐post study

Sium,

Tolu,

Wolderufael

et al. 2024

Intl J Gynecology & Obste

Self Cite

View full text Add to dashboard Cite

ObjectiveTo investigate whether routine intraoperative ultrasonographic guidance during second‐trimester dilatation and evacuation (D&E) reduces procedure‐related complications in an Ethiopian setting.MethodsWe conducted a pre‐post study on routine ultrasonography during second‐trimester D&E at St. Paul's Hospital Millennium Medical College (Ethiopia). Second‐trimester D&E cases that were managed at the hospital between 2017 and 2022 were retrospectively analyzed by grouping them into an intervention group (using routine ultrasound intraoperatively for all cases) and a non‐intervention group (problem‐based intraoperative use of ultrasound, where ultrasound was used in problem cases only). SPSS version 23 was used for analysis and simple descriptive statistics, χ2 test, multivariate regression analysis, and Fisher exact test were performed as appropriate. P values less than 0.05 and odds ratio with 95% CI were used to present the results' significance.ResultsA total of 242 second‐trimester D&E cases were analyzed (84 cases managed under routine intraoperative ultrasound guidance and 158 cases managed with a problem‐based intraoperative use of ultrasound). Compared with problem‐based intraoperative use of ultrasound (using it only in selected cases), routine intraoperative ultrasound use was not associated with a decrease in D&E complications (adjusted odds ratio [aOR] 0.22, 95% confidence interval [CI] 0.04–1.16). The two factors associated with increased D&E procedure complications were advanced gestational age (aOR 13.52, 95% CI 1.86–98.52), and need for additional mechanical cervical dilatation during the D&E procedure (aOR 9.53, 95% CI 1.32–69.07). Provider experience, cervical preparation methods (laminaria vs Foley), and maternal age were not associated with occurrence of D&E complications.ConclusionOur study does not support the preference of routine intraoperative ultrasound guidance over problem‐based (in selected cases) intraoperative ultrasound use during the second‐trimester D&E procedure. More research is needed to make a strong clinical recommendation on using routine intraoperative ultrasound guidance during all second‐trimester D&E procedures.

show abstract

Section: Discussionmentioning

confidence: 99%