Document Detail

Sotalol as first line treatment in fetal tachycardias and neonatal follow-up.
MedLine Citation:
PMID:  23303470     Owner:  NLM     Status:  Publisher    
OBJECTIVES: In fetal tachycardia pharmacologic therapy with digoxin, flecainide and sotalol has been reported to be effective. In a recent retrospective multicentre study sotalol was considered to be less effective than the others in fetal SVT. The aim of this study is to re-evaluate the efficacy and safety of maternally administered sotalol in the treatment of fetal tachycardia. METHODS: Charts of 30 consecutive referrals with M-mode echocardiographically documented fetal tachycardia were reviewed retrospectively and discussed with reports from literature. RESULTS: A total of 28 patients were treated with first line sotalol (SVT: 18; AF: 10). Fetal hydrops was present in six patients (SVT: 5, AF: 1). All hydropic patients converted antenatally to sinus rhythm (SR) (67% with sotalol as a single therapy; 33% after addition of flecainide). Of the nonhydropic patients, 91% converted to SR (90% with sotalol only, 10% after addition of flecainide or digoxin). In 9% (AF) rate control was achieved. There was no mortality. No serious drug-related adverse events were observed. Postnatally, rhythm disturbances were detected in ten patients: two were still in AF. In eight SVT was observed within three weeks postnatally, five of whom within 72 hours. CONCLUSIONS: Sotalol can be recommended as drug of first choice in the treatment of fetal AF and has shown to be an effective and safe first line treatment option for SVT, at least in the absence of hydrops. Postnatal maintenance therapy after successful prenatal therapy is not necessarily indicated, as the risk of recurrence is low beyond 72 hours of age.
Laila B van der Heijden; Martijn A Oudijk; Wendy Manten; Henriette Ter Heide; Lou Pistorius; Matthias W Freund
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-10
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 ISUOG. Published by John Wiley & Sons, Ltd.
Department of Pediatric Cardiology, University Medical Centre Utrecht, The Netherlands.
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