{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T06:58:22Z","timestamp":1773298702671,"version":"3.50.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T00:00:00Z","timestamp":1695600000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T00:00:00Z","timestamp":1695600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Reprod. Sci."],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Feticide is the practice of inducing fetal demise before the termination of pregnancy. In England and Wales, it is recommended for terminations of pregnancy beyond 21+6 weeks of gestation. This project analyses the trends in feticide in singleton pregnancy in England and Wales between 2012 and 2020.\u00a0This project was a retrospective study that analysed data extracted from the Health and Social Act 4 (HSA4) forms submitted to the Department of Health and Social Care (DHSC). The data extracted by the DHSC included the prevalence of feticide, methods of feticide and termination, statutory grounds, gestation, service provider, maternal age, ethnicity and obstetric history. In addition, data analysis was carried out to identify trends.\u00a0Between 2012 and 2020, there were 9310 feticides in England and Wales, undertaken in 0.5% of all abortions. The prevalence of feticide fluctuated; however, there was an overall decrease from 1084 cases in 2012 to 1000 cases in 2020. Intracardiac injection of potassium chloride was the most frequent method of achieving feticide (67.2%). Just over half (55.8%) of feticides took place under Ground E of the Abortion Act 1967, with the main indication being congenital malformations of the nervous system. Two-fifths (40.2%) of feticides took place at 23 weeks, 22.8% at 22 weeks and 13.5% between 20 and 21 weeks. The remainder occurred at later gestations: 17.5% at 24\u201329 weeks and 5.9% beyond 29 weeks. During our study period, it was more common for feticides to be carried out as part of a medical termination than a surgical termination and 60.3% occurred in NHS hospitals. Women undergoing feticide were mostly aged 30\u201334 years (38.3%) and of White ethnicity (78.6%).\u00a0Feticide is an essential component of comprehensive abortion care for women undergoing late second and third-trimester abortions. This study provides insight into how feticide is carried out in England and Wales and demonstrates the effect of the COVID-19 pandemic on reducing feticide prevalence. Future research should analyse in more detail the use of the different methods of feticide.<\/jats:p>","DOI":"10.1007\/s43032-023-01352-3","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T13:01:42Z","timestamp":1695646902000},"page":"441-451","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Feticide Before Termination of Pregnancy in Singleton Pregnancy \u2013 Trends in England and Wales 2012\u20132020, a Cross-sectional Study"],"prefix":"10.1007","volume":"31","author":[{"given":"Isabelle","family":"Schiff","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2750-8405","authenticated-orcid":false,"given":"Panicos","family":"Shangaris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Grinsted","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srividhya","family":"Sankaran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,9,25]]},"reference":[{"key":"1352_CR1","unstructured":"World Health Organization. Safe abortion: technical and policy guidance for health systems. 2nd ed. Geneva: World Health Organization;\u00a02012. https:\/\/apps.who.int\/iris\/handle\/10665\/70914. Accessed 16 Apr 2022."},{"key":"1352_CR2","unstructured":"The Abortion Act. 1967.\u00a0https:\/\/www.legislation.gov.uk\/ukpga\/1967\/87\/contents. Accessed 26 Jan 2022."},{"key":"1352_CR3","unstructured":"Royal College of Obstetricians and Gynaecologists (RCOG). Termination of pregnancy for fetal abnormality in England, Wales, and Scotland. 2010."},{"key":"1352_CR4","doi-asserted-by":"publisher","first-page":"ii15","DOI":"10.1136\/jme.27.suppl_2.ii15","volume":"27","author":"J Wyatt","year":"2001","unstructured":"Wyatt J. Medical paternalism and the fetus. J Med Ethics. 2001;27:ii15\u201320.","journal-title":"J Med Ethics"},{"key":"1352_CR5","doi-asserted-by":"publisher","first-page":"F208","DOI":"10.1136\/archdischild-2017-312748","volume":"103","author":"S Santhakumaran","year":"2018","unstructured":"Santhakumaran S, Statnikov Y, Gray D, Battersby C, Ashby D, Modi N. Survival of very preterm infants admitted to neonatal care in England 2008\u20132014: time trends and regional variation. Arch Dis Child Fetal Neonatal Ed. 2018;103:F208\u201315.\u00a0https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/archdischild-2017-312748","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"1352_CR6","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1001\/jama.2019.2021","volume":"321","author":"M Norman","year":"2019","unstructured":"Norman M, Hallberg B, Abrahamsson T, Bj\u00f6rklund LJ, Domell\u00f6f M, Farooqi A, et al. Association between year of birth and 1-year survival among extremely preterm infants in Sweden during 2004-2007 and 2014-2016. JAMA. 2019;321:1188.\u00a0http:\/\/jama.jamanetwork.com\/article.aspx?doi=10.1001\/jama.2019.2021","journal-title":"JAMA"},{"key":"1352_CR7","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1007\/s00404-021-06042-6","volume":"304","author":"DA Muin","year":"2021","unstructured":"Muin DA, Otte P, Scharrer A, Kasprian G, Husslein PW, Kiss H, et al. Temporal changes in epidemiological profile and fetal indications for late termination of pregnancy: a retrospective single-center study. Arch Gynecol Obstet. 2021;304:935\u201342.","journal-title":"Arch Gynecol Obstet"},{"key":"1352_CR8","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1002\/ijgo.13419","volume":"153","author":"LB Tolu","year":"2021","unstructured":"Tolu LB, Tufa TH, Abas F, Kahn C, MacAfee L, Prager S, et al. Intra-cardiac lidocaine administration to induce fetal demise before late second-trimester abortion: retrospective review. Int J Gynecol Obstet. 2021;153:125\u20139.","journal-title":"Int J Gynecol Obstet"},{"key":"1352_CR9","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1159\/000520448","volume":"48","author":"R Rayssiguier","year":"2021","unstructured":"Rayssiguier R, Fuchs F, Mousty E, Morau E, Hlioua T, Wells C, et al. Use of remifentanil associated with lidocaine for feticides in late terminations of pregnancy: a randomized clinical trial. Fetal Diagn Ther. 2021;48:812\u20138.","journal-title":"Fetal Diagn Ther"},{"key":"1352_CR10","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1046\/j.1471-0528.2003.02217.x","volume":"110","author":"MV Senat","year":"2003","unstructured":"Senat MV, Fischer C, Bernard JP, Ville Y. The use of lidocaine for fetocide in late termination of pregnancy. BJOG. 2003;110:296\u2013300.","journal-title":"BJOG."},{"key":"1352_CR11","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1111\/1471-0528.15640","volume":"126","author":"M Sharvit","year":"2019","unstructured":"Sharvit M, Klein Z, Silber M, Pomeranz M, Agizim R, Schonman R, et al. Intra-amniotic digoxin for feticide between 21 and 30 weeks of gestation: a prospective study. BJOG. 2019;126:885\u20139.","journal-title":"BJOG."},{"key":"1352_CR12","first-page":"471","volume":"97","author":"RA Jackson","year":"2001","unstructured":"Jackson RA, Teplin VL, Drey EA, Thomas LJ, Darney PD. Digoxin to facilitate late second-trimester abortion: a randomized, masked, placebo-controlled trial. Obstet Gynecol. 2001;97:471\u20136.","journal-title":"Obstet Gynecol"},{"key":"1352_CR13","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.contraception.2007.10.011","volume":"77","author":"M Molaei","year":"2008","unstructured":"Molaei M, Jones HE, Weiselberg T, McManama M, Bassell J, Westhoff CL. Effectiveness and safety of digoxin to induce fetal demise prior to second-trimester abortion. Contraception. 2008;77:223\u20135.","journal-title":"Contraception."},{"key":"1352_CR14","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/j.contraception.2010.01.018","volume":"81","author":"J Diedrich","year":"2010","unstructured":"Diedrich J, Drey E. Induction of fetal demise before abortion. SFP Guideline 20101, Release date January 2010. Contraception. 2010;81:462\u201373.","journal-title":"Contraception."},{"key":"1352_CR15","unstructured":"World Health Organization. Safe abortion: technical and policy guidance for health systems [Internet] [cited 2022 Dec 19].\u00a0https:\/\/apps.who.int\/iris\/handle\/10665\/70914"},{"key":"1352_CR19","doi-asserted-by":"publisher","first-page":"2202","DOI":"10.1111\/aogs.14230","volume":"100","author":"A Edling","year":"2021","unstructured":"Edling A, Lindstr\u00f6m L, Bergman E. Second trimester induced abortions due to fetal anomalies\u2014a population-based study of diagnoses, examinations and clinical management. Acta Obstet Gynecol Scand. 2021;100:2202\u20138.","journal-title":"Acta Obstet Gynecol Scand"},{"key":"1352_CR16","unstructured":"Department of Health and Social Care (DHSC). Procedures for the approval of independent sector places for termination of pregnancy (abortion) in England. 2020. Available at: https:\/\/www.gov.uk\/government\/publications\/update-to-procedures-for-the-approval-of-independent-sector-places-published\/procedures-for-the-approval-of-independent-sector-places-for-termination-of-pregnancy-abortion-in-england. Accessed 23 Mar 2022."},{"key":"1352_CR17","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1055\/s-0036-1585410","volume":"34","author":"K Goetzinger","year":"2016","unstructured":"Goetzinger K, Shanks A, Odibo A, Macones G, Cahill A. Advanced maternal age and the risk of major congenital anomalies. Am J Perinatol. 2016;34:217\u201322.","journal-title":"Am J Perinatol"},{"key":"1352_CR18","unstructured":"Office for National Statistics. Conceptions in England and Wales [Internet] [cited 2022 Dec 19].\u00a0https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/conceptionandfertilityrates\/datasets\/conceptionstatisticsenglandandwalesreferencetables"}],"container-title":["Reproductive Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43032-023-01352-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s43032-023-01352-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43032-023-01352-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T13:15:28Z","timestamp":1706620528000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s43032-023-01352-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,25]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["1352"],"URL":"https:\/\/doi.org\/10.1007\/s43032-023-01352-3","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-2399012\/v1","asserted-by":"object"}]},"ISSN":["1933-7191","1933-7205"],"issn-type":[{"value":"1933-7191","type":"print"},{"value":"1933-7205","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,25]]},"assertion":[{"value":"20 December 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 September 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 September 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No ethics approval was required for this study. This was confirmed by the NHS Health Research Authority and R&D at Guy\u2019s and St Thomas\u2019 Hospital.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"Dr Panicos Shangaris is the Editor of Social Media and Emerging Technologies (ESMET) of the Reproductive Sciences Journal. He had no involvement in handling, assigning reviewers or reviewing the manuscript. The rest of the authors have no conflict of interest to declare. There are no relevant financial, personal, political, intellectual or religious interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}