Termination for fetal abnormality or death

Women who present for termination of pregnancy because of fetal abnormality or intrauterine death present a difficult clinical problem. Induction of labour is usually required and this may be a long and tedious process involving the use of prosta-glandin pessaries and Syntocinon infusion (see Chapter 71, Intrauterine death, p. 170).

Termination of a pregnancy at less than 28 weeks is often associated with the retention of products of conception, for which surgical evacuation and anaesthesia are required. Either regional or general anaesthesia may be offered to the woman, balancing the risks and benefits of each depending on the clinical condition and whether epidural analgesia is already in place. Rapid sequence induction and tracheal intubation may be appropriate.

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