Intra-cardiac lidocaine administration to induce fetal demise before late second trimester abortion, Retrospective review.

OBJECTIVE To determine the efficacy and safety of intra-cardiac lidocaine administration to induce fetal demise prior to second trimester medication abortion in a teaching hospital in Addis Ababa, Ethiopia. STUDY DESIGN We performed a retrospective chart review to collect selected sociodemographic and clinical information. All clients who received fetal intra-cardiac lidocaine between January 1, 2019 and April 30, 2019 were included in the study. Fetal demise was considered successful if achieved within 24 hours after fetal intra-cardiac lidocaine administration. We analyzed the data using SPSS version 20. We used frequency tables to describe the data and performed a multivariable analysis to determine associations between variables. RESULTS A total of 80 clients were administered intra-cardiac lidocaine.The mean gestational age was 23 weeks 1 day (range 21 weeks to 27 weeks 5 days). Twenty-four hours after lidocaine administration 76 (95%) clients had negative fetal cardiac activity. Clients at gestational ages of 21-23 weeks 6 days were five times more likely to have negative cardiac activity compared to those with gestational ages between 24 and 28 weeks (P-value = 0.001). Two patients developed nausea, vomiting and a metallic taste, but no serious adverse events were reported. CONCLUSIONS Intra-cardiac lidocaine is effective at inducing fetal demise before late second trimester medication abortion with no associated serious adverse events or complications.