Historically, second trimester termination was performed by intra-amniotic instillation of 20 percent hypertonic saline. Which serious systemic complication is this method classically associated with?

• A Severe hypoglycaemia with convulsions
• B Disseminated intravascular coagulation and hypernatraemia ✓
• C Malignant hyperthermia
• D Isolated cervical laceration without systemic effects

Explanation

Hypertonic saline instillation is classically linked to disseminated intravascular coagulation, thought to result from release of thromboplastin-rich placental and fetal material into the circulation, together with hypernatraemia if saline enters maternal vessels. Water intoxication occurred with the related technique of extra-amniotic hypotonic solutions. Because of these dangers, saline instillation was abandoned and superseded by prostaglandins and mifepristone based regimens, which are safer and faster.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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