Document Detail


Therapeutic trial of sympathomimetics in three cases of complete heart block in the fetus.
MedLine Citation:
PMID:  8521558     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A total of 36 fetuses with isolated congenital complete heart block and structurally normal hearts have been seen in the department of fetal echocardiography since 1980. Although the prognosis is good in the majority of cases, those who develop intrauterine cardiac failure have a high mortality. The aim of this study was to investigate the contribution to management of sympathomimetic therapy by comparing two possible agents administered to the mothers. METHODS AND RESULTS: The effect of two sympathomimetic agents, isoprenaline and salbutamol, was compared in three patients with isolated complete heart block. Fetal heart rate and indexes of cardiac function were monitored during therapy. Maternal cardiovascular status was also regularly assessed. Dosage of isoprenaline increased from 1 to 12 micrograms/min, and salbutamol increased from 4 to 64 micrograms/min during the trial. No significant change was detected with isoprenaline therapy, but all fetuses showed an increase in heart rate and improvement in ventricular function with salbutamol. Salbutamol was maintained until delivery in one case with evidence of cardiac failure, with resolution of fetal hydrops. All three delivered in good condition close to term. Two of three required pacing in the neonatal period. CONCLUSIONS: We conclude that salbutamol can be effective in the treatment of fetal complete heart block and should be considered in patients with this condition where there is evidence of deteriorating cardiac function.
Authors:
A M Groves; L D Allan; E Rosenthal
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Publication Detail:
Type:  Case Reports; Comparative Study; Journal Article    
Journal Detail:
Title:  Circulation     Volume:  92     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1995 Dec 
Date Detail:
Created Date:  1996-01-23     Completed Date:  1996-01-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  3394-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Fetal Cardiology, Guy's Hospital, London, England.
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MeSH Terms
Descriptor/Qualifier:
Albuterol / therapeutic use*
Echocardiography
Female
Fetal Diseases / drug therapy*,  ultrasonography
Heart Block / drug therapy*,  ultrasonography
Heart Rate, Fetal / drug effects
Humans
Infant, Newborn
Infusions, Intravenous
Isoproterenol / therapeutic use*
Male
Pregnancy
Sympathomimetics / therapeutic use*
Chemical
Reg. No./Substance:
0/Sympathomimetics; 18559-94-9/Albuterol; 7683-59-2/Isoproterenol

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


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