{
    "abstract": "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.\nThe 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.\nA 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.\nDuring 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.\nIt 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.",
    "authors": [
        {
            "affiliation": "Obstetrics and Gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia tesfaye.hurisa@sphmmc.edu.et.\nSexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.",
            "firstname": "Tesfaye Hurissa",
            "initials": "TH",
            "lastname": "Tufa"
        },
        {
            "affiliation": "Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.",
            "firstname": "Antonella Francheska",
            "initials": "AF",
            "lastname": "Lavelanet"
        },
        {
            "affiliation": "Obstetrics and Gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.\nSexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.",
            "firstname": "Lemi",
            "initials": "L",
            "lastname": "Belay"
        },
        {
            "affiliation": "Obstetrics and Gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.",
            "firstname": "Berhanu",
            "initials": "B",
            "lastname": "Seboka"
        },
        {
            "affiliation": "Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA.",
            "firstname": "Jason",
            "initials": "J",
            "lastname": "Bell"
        }
    ],
    "conclusions": "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.",
    "copyrights": "\u00a9World Health Organization 2020. Licensee BMJ.",
    "doi": "10.1136/bmjsrh-2019-200396\n10.1016/S0140-6736(16)30380-4\n10.1016/S0968-8080(10)36521-9\n10.1155/2015/256534\n10.1186/1742-4755-4-7\n10.1016/j.contraception.2010.01.018\n10.1067/mob.2000.105438\n10.1016/s0029-7844(00)01148-0\n10.1016/j.contraception.2007.10.011\n10.1111/1471-0528.15640\n10.1016/j.contraception.2011.01.005\n10.1363/42e1916\n10.1016/j.contraception.2013.08.005",
    "journal": "BMJ sexual & reproductive health",
    "keywords": [
        "abortion",
        "education and training",
        "general practice"
    ],
    "methods": null,
    "publication_date": "2020-04-04",
    "pubmed_id": "32241827\n27179755\n21111352\n25918704\n17883835\n20472112\n10819828\n8423969\n11239659\n18279695\n30703286\n22067811\n28825903\n24034581",
    "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.",
    "title": "Feasibility of intra-amniotic digoxin administration by obstetrics and gynecology trainees to induce fetal demise prior to medical abortion beyond 20 weeks.",
    "xml": "<Element 'PubmedArticle' at 0x788505b136a0>"
}