WHAT TO EXPECT
Day of Arrival
On your day of arrival, you will be told of a designated area to meet based on when you arrive to the D.C. area by plane, train, car, or other form of transportation. That individual will pick up you and your significant other as there will be only one other person to come with you to the facility due to privacy and security issues for the patient and staff.
Upon arrival to the facility, you will first be greeted by warm, friendly, and compassionate staff that will make you comfortable and give you a medical history form to complete and sign.
Most patients would have had their labs done before coming to our facility. For those that have not, in the laboratory testing phase of your visit you will be asked to provide a urine sample and a small amount of blood will be taken from your finger to determine whether or not your pregnancy test is positive, if you have a low red blood cell count (anemia) and your Rh factor. Your pre-operative vital signs (blood pressure, pulse and temperature) will also be taken.
A sonogram (ultrasound) will be performed to determine the length of your pregnancy.
Abortion can be one of the most difficult decisions a woman may ever have to make. In the United States alone there are approximately 1.3 million unwanted pregnancies that result in abortion. It is one of the most commonly performed medical procedures. The decision to have an abortion is very complex. The reasons women want to terminate their pregnancies vary. The most common are 1) they cannot afford to have a child; 2) they need to take care of the children and family they already have; and 3) having a child would interfere significantly with their current life path and could potentially lead to a hindrance of planning for future goals such as completing their education.
There are many other reasons which can include difficulty with significant other, recent death of a partner, severe medical problems, and possibly rape or incest. These are only a few. No woman wants to have an abortion. She alone has her reasons. During your counseling session the alternatives to abortion will be discussed, along with describing the fetal intra-cardiac injection procedure.
Arrangements would have already been made prior to your arrival where the evacuation of the intrauterine content (pregnancy) will take place. If arrangements are not in place for labor induction and surgical removal of the pregnancy, then the intra-cardiac injection will not take place.
Fetal Intra-cardiac Injection:
The patient is taken to the procedure room where she is placed on an exam table. If patient elects to have a mild IV sedative it is given at this point. The patient's abdomen is cleansed with an anti-septic solution. A sonogram sector scan is placed on the patient's abdomen and the fetal abdominal cavity is isolated. A spinal needle is guided slowly into the fetal heart where a feticide agent or 50cc's of air is injected via a syringe to stop the fetal heart beat. The procedure usually takes 2 to 4 minutes to perform. The patient is then observed for several minutes in the procedure room.
Complications associated with fetal intra-cardiac injection:
With or without IV Sedation patients are able to go home in 10 to 15 minutes after the procedure is performed. The majority of patients experience no pain or discomfort following the procedure. Some patients experience very mild cramping and contractions for 2 to 5 mins after the procedure. There are some women who experience vaginal spotting or bleeding. It is extremely rare but complete or partial separation of the placenta (abruption) can occur along with heavy vaginal bleeding. There have been rare occasions where infection of the amniotic fluid (amnionitis), the intrauterine cavity (Endometritis), or the muscle of the uterus (myometritis) occurs. It is extremely rare but maternal death has occurred due to sepsis (infection getting into the mother's blood) or severe vaginal bleeding. The incidence of any of these complications occurring is very rare and has never been seen by me but must be discussed in order for patients to be fully informed. Once we have determined that you are ready to leave the office, you will be given your post-op packet with instructions on how to care of yourself until you follow-up with your personal physician or the proper referral where the evacuation of the uterus will be carried out.
You will be given a 24 hour number to contact if you have any concerns or questions after leaving the office. Our medical staff and physicians are on call 24 hours a day, 7 days a week.