Document Detail


Fetal supraventricular tachycardia diagnosed and treated at 13 weeks of gestation: a case report.
MedLine Citation:
PMID:  12666229     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Supraventricular tachycardia (SVT) is the most commonly encountered clinically significant tachycardia in the fetus. When SVT is sustained, congestive heart failure and fetal hydrops may ensue, due to both systolic and diastolic dysfunction. Sonographic diagnosis is usually incidental during the second or third trimester. Treatment goals are cardioversion to sinus rhythm and reversal of cardiac dysfunction. We describe a case of fetal SVT diagnosed at 13 weeks of gestation. Treatment with digoxin and flecainide was successful; the heart rate returned to sinus rhythm within one day, and fetal hydrops resolved within 8 days of treatment. We suspect that as more first-trimester examinations are performed, more cases with SVT will be diagnosed. We discuss the treatment protocol, and suggest that co-administration of two drugs that act synergistically may be more efficient than monotherapy, which is currently used as the first line of treatment. In addition, we discuss the potentially deleterious effect of heart failure encountered at an early developmental stage on the central nervous system. More data need to be collected in order to substantiate a clear recommendation regarding optimal management.
Authors:
S Porat; E Y Anteby; Y Hamani; S Yagel
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  21     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-31     Completed Date:  2003-05-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  302-5     Citation Subset:  IM    
Copyright Information:
Copyright 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics and Gynecology, Hadassah University Hospital-Mt. Scopus, Jerusalem, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Arrhythmia Agents / therapeutic use
Digoxin / therapeutic use
Female
Flecainide / therapeutic use
Gestational Age
Humans
Hydrops Fetalis / complications*,  drug therapy,  ultrasonography
Pregnancy
Tachycardia, Supraventricular / complications,  drug therapy,  ultrasonography*
Ultrasonography, Doppler
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 20830-75-5/Digoxin; 54143-55-4/Flecainide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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