Anaesthesia of foetus in late (20w+) TFMR on NHS?

[GingerJulep]

Firstly please let me say this is purely a request for information to help me make a better informed personal choice - definitely not intended to start a debate/imply criticism of any particular course of action.

If abnormalities are found on a 20w scan and you are offered TFMR does the NHS routinely (or on request) provide pain relief for the foetus before/during/after the procedure?

Thank you

Looking into this I've found that with L&D at 21w+ an injection can be given to foetus before hand to ensure it dies before the L&D. ARC didn't seem to have further info on what is used/what it feels (in an adult) like or why it isn't always done.

If people don't want to share their own experiences (and it has taken me a couple of years to become comfortable talking about my own very early termination so I totally understand that) are there any other sources of info I can look at?

I don't know a lot about the procedure as we don't offer this where I work. What happens is women who have a tfmr go to another hospital where they offer an injection into the foetus to stop its heart. I believe this injection is directly into the heart.

Then they come back to our hospital to deliver. So the foetus has died before going through labour.

Whether the injection is painful or not I don't know. Sorry that's maybe not any help to you/maybe what you already knew.

Fetacide is usually done a couple of days before labour is induced.
The fetal heart is injected with potassium to stop it.

I am guessing...
They couldn't do a lot that would impact the fetus without killing it anyway & maybe risking mother's life too (imagine the mother given a very heavy sedative in hope enough might reach the fetus). A jab for pain relief would hurt as much as the jab that stops the heart.

Thank you both - that is really helpful and has allowed me to find out more info.

It seems that this is done for the benefit of medical professionals/parents (which are obviously very valid concerns) www.ncbi.nlm.nih.gov/pubmed/1635748

Sadly potassium is also used in lethal injections for execution so I've been able to find more info about the effects there. Clearly different to a direct injection into the heart, but provides enough info for me to make/validate my own decision.

Thank you both

lljkk - agree about jabs being jabs whatever they are administering but obviously depth of jab required/sensation of substance being administered makes a difference too.

Thank you for adding to this difficult topic.

Hi Ginger. I have tfmr-ed at 20wks and 29wks. In both cases my babies were given a potassium chloride injection into their heart. Similar to a cvs or amino (I've had both) , a long needle was inserted into my stomach into my babies. There is no local anaesthetic needed as it is not physically painful (but psychologically devastating) . I do not believe either of my babies suffered while this happened. It was monitored by ultrasound so they knew when it had worked. It was done so that my babies weren't alive when they were born. They both had severe brain abnormalities. It turned out that they both had unbalanced chromosomal translocations, but we didn't know it at the time. I don't think much work has been done to assess the impact of the injection on the psychological health of the mother as it is an absolutely awful thing to go through, even if you think you are doing it for the right reasons.

I had a similar experience to mb2512cat, with a tfmr at nearly 27 weeks. I was told that my baby did not suffer from the injection and that it is to prevent the baby being born alive, to both prevent it's suffering, protect the mental health of the parents and so that medical professionals do not need to intervene to preserve its life. I was then given medication to halt the pregnancy hormones and was brought back into the hospital 48 hours later to be induced.

I also agree that this, psychologically, was the hardest part of the whole process for me, even though I was doing it to prevent the inevitable suffering she would have experienced during/ post birth.