{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T18:34:51Z","timestamp":1770834891851,"version":"3.50.1"},"reference-count":19,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"published-print":{"date-parts":[[2020,10]]},"abstract":"\n Background<\/jats:title>\n Transient fetal survival is one issue that providers may face while\n managing late second-trimester abortion. Induction of fetal demise using\n digoxin and other means has been widely performed by maternal\u2013fetal\n medicine and family planning subspecialists worldwide. However, there\n are no data available in Ethiopia as regards preventing transient fetal\n survival in late second-trimester medical termination of\n pregnancy.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The objective of the study was to document the feasibility of\n intra-amniotic digoxin administration for inducing fetal demise prior to\n medical abortion beyond 20 weeks of gestational age. Additionally, we\n aimed to demonstrate that this skill could be transferred to obstetrics\n and gynaecology residents at St Paul\u2019s Hospital Millennium Medical\n College in Addis\n Ababa<\/jats:named-content>, Ethiopia<\/jats:named-content>.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective cross-sectional study design was conducted to\n document the feasibility, safety and effectiveness of intra-amniotic\n digoxin. A structured questionnaire was used to collect selected\n sociodemographic data and clinical characteristics. Data were entered\n and analysed using SPSS statistical package version 20.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n During the study period, 49 women received intra-amniotic digoxin.\n The success rate of intra-amniotic digoxin in this study was 95.9%.\n Thirty-seven (75.5%) procedures were performed by obstetrics and\n gynaecology residents and 12 (24.5%) were performed by family planning\n faculties. There were two out of hospital expulsions with no signs of\n life, and no other serious maternal complications were\n observed.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n It is feasible for obstetrics and gynaecology trainees in Ethiopia\n to learn how to safely administer intra-amniotic digoxin to induce fetal\n demise for induced medical terminations.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjsrh-2019-200396","type":"journal-article","created":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T02:38:54Z","timestamp":1618972734000},"page":"308-312","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Feasibility of intra-amniotic digoxin administration by obstetrics and\n gynecology trainees to induce fetal demise prior to medical abortion beyond\n 20 weeks"],"prefix":"10.1136","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8623-9113","authenticated-orcid":false,"given":"Tesfaye Hurissa","family":"Tufa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella Francheska","family":"Lavelanet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lemi","family":"Belay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berhanu","family":"Seboka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Bell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,4,2]]},"reference":[{"key":"2021041920401676000_46.4.308.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30380-4"},{"key":"2021041920401676000_46.4.308.2","first-page":"e12924","article-title":"Recent trends in induced abortions: a global perspective","volume":"15","author":"LaVecchia","year":"2018","journal-title":"Epidemiol Biostat Public Health"},{"key":"2021041920401676000_46.4.308.3","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/S0968-8080(10)36521-9","article-title":"Second trimester abortion laws globally: actuality, trends and recommendations","volume":"18","author":"Boland","year":"2010","journal-title":"Reprod Health Matters"},{"key":"2021041920401676000_46.4.308.4","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/482023"},{"key":"2021041920401676000_46.4.308.5","doi-asserted-by":"crossref","unstructured":"Harries J , Orner P , Gabriel M , et al . Delays in\n seeking an abortion until the second trimester: a qualitative study in\n South Africa. Reprod Health 2007;4:7.\n doi:10.1186\/1742-4755-4-7","DOI":"10.1186\/1742-4755-4-7"},{"key":"2021041920401676000_46.4.308.6","unstructured":"World Health Organization (WHO) . Safe abortion:\n technical & policy guidance for health systems. 2nd edn. Geneva: WHO\n Press, 2015."},{"key":"2021041920401676000_46.4.308.7","unstructured":"Royal College of Obstetricians and Gynaecologists\n (RCOG) . Report of the RCOG Ethics Committee on a consideration of the\n law and ethics in relation to late termination of pregnancy for fetal\n abnormality. London: RCOG, 1998."},{"key":"2021041920401676000_46.4.308.8","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/j.contraception.2010.01.018","article-title":"Induction of fetal demise before abortion","volume":"81","author":"Diedrich","year":"2010","journal-title":"Contraception"},{"key":"2021041920401676000_46.4.308.9","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1067\/mob.2000.105438","article-title":"Safety of intra-amniotic digoxin administration before late second-trimester abortion by dilation and evacuation","volume":"182","author":"Drey","year":"2000","journal-title":"Am J Obstet Gynecol"},{"key":"2021041920401676000_46.4.308.10","first-page":"301","article-title":"Outpatient abortion for fetal anomaly and fetal death from 15-34 menstrual weeks' gestation: techniques and clinical management","volume":"81","author":"Hern","year":"1993","journal-title":"Obstet Gynecol"},{"key":"2021041920401676000_46.4.308.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(00)01148-0"},{"key":"2021041920401676000_46.4.308.12","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.contraception.2007.10.011","article-title":"Effectiveness and safety of digoxin to induce fetal demise prior to second-trimester abortion","volume":"77","author":"Molaei","year":"2008","journal-title":"Contraception"},{"key":"2021041920401676000_46.4.308.13","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1111\/1471-0528.15640","article-title":"Intra-amniotic digoxin for feticide between 21 and 30 weeks of gestation: a prospective study","volume":"126","author":"Sharvit","year":"2019","journal-title":"BJOG"},{"key":"2021041920401676000_46.4.308.14","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.contraception.2011.01.005","article-title":"Infection and extramural delivery with use of digoxin as a feticidal agent","volume":"85","author":"Steward","year":"2012","journal-title":"Contraception"},{"key":"2021041920401676000_46.4.308.15","doi-asserted-by":"crossref","unstructured":"Paul M , Lichtenberg S , Borgatta L . Management of\n unintended and abnormal pregnancy: comprehensive abortion care. Hoboken,\n NJ: Wiley-Blackwell, 2009.","DOI":"10.1002\/9781444313031"},{"key":"2021041920401676000_46.4.308.16","unstructured":"Federal Democratic Republic of Ethiopia Ministry of\n Health . Health sector development program IV, 2010\/11-2014\/15. Addis\n Ababa, Ethiopia, 2010."},{"key":"2021041920401676000_46.4.308.17","unstructured":"Federal Ministry of Health . Technical and procedural\n guidelines for safe abortion services in Ethiopia. 2nd edn,\n 2013."},{"key":"2021041920401676000_46.4.308.18","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1363\/42e1916","article-title":"Changes in morbidity and abortion care in Ethiopia after legal reform: national results from 2008 and 2014","volume":"42","author":"Gebrehiwot","year":"2016","journal-title":"Int Perspect Sex Reprod Health"},{"key":"2021041920401676000_46.4.308.19","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1016\/j.contraception.2013.08.005","article-title":"Feasibility, effectiveness and safety of transvaginal digoxin administration prior to dilation and evacuation","volume":"88","author":"Tocce","year":"2013","journal-title":"Contraception"}],"container-title":["BMJ Sexual & Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsrh-2019-200396","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T02:39:09Z","timestamp":1618972749000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1136\/bmjsrh-2019-200396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,2]]},"references-count":19,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,10,12]]},"published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1136\/bmjsrh-2019-200396"],"URL":"https:\/\/doi.org\/10.1136\/bmjsrh-2019-200396","relation":{},"ISSN":["2515-1991","2515-2009"],"issn-type":[{"value":"2515-1991","type":"print"},{"value":"2515-2009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,2]]}}}