Transvaginal administration of intraamniotic digoxin prior to dilation and evacuation

Aileen M. Gariepy, Beatrice A. Chen, Heather L. Hohmann, Sharon L. Achilles, Jennefer A. Russo, Mitchell D Creinin

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background: Transabdominal injection of digoxin into the amniotic fluid or fetus to induce fetal demise before dilation and evacuation (D&E) abortion has become common practice since the passage of the Partial-Birth Abortion Ban Act in 2007. Study Design: We performed a prospective study to assess the feasibility of transvaginal administration of intraamniotic digoxin the day before D&E. All women between 18 0/7 and 23 5/7 weeks of gestation seeking termination from December 2009 to May 2011 were approached for study participation. Women who declined participation were asked to identify their primary rationale. For women declining study participation, transection of the umbilical cord during D&E was performed to meet the requirements of the ban. Results: Over 18 months, 134 women met study entry criteria and 108 (81%) declined to participate. Of the 26 women who enrolled, 1.0 mg undiluted digoxin was successfully administered transvaginally in 24 (92%, 95% confidence interval 75%-99%). The most common reasons for declining participation were discomfort with preoperatively inducing fetal demise (37%) and desire to avoid a medically unnecessary medication (36%). Conclusions: Transvaginal administration of digoxin is a feasible alternative to transabdominal administration to induce preoperative fetal demise. The majority of women decline digoxin administration when an alternative is available.

Original languageEnglish (US)
Pages (from-to)76-80
Number of pages5
Issue number1
StatePublished - Jan 2013


  • Abortion
  • Digoxin
  • Dilation and evacuation
  • Fetal demise
  • Transvaginal

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology


Dive into the research topics of 'Transvaginal administration of intraamniotic digoxin prior to dilation and evacuation'. Together they form a unique fingerprint.

Cite this