Antonia W Shand1, Jan E Dickinson, Luigi D'Orsogna. 1. Maternal Fetal Medicine Service, King Edward Memorial Hospital for Women, The University of Western Australia, Perth, WA, Australia.
Abstract
OBJECTIVE: Supraventricular tachycardia (SVT) is the most common form of sustained fetal tachyarrhythmia in pregnancy. The development of hydrops with SVT is associated with significant worsening of prognosis. CASE: We report a case of fetal SVT with hydrops at 28 weeks' gestation that required both transplacental and direct fetal treatment in a woman with concurrent obstetric cholestasis. Antiarrhythmic therapy and control of the maternal liver function and bile acid levels with ursodeoxycholic acid was associated with a fetal response to treatment resulting in a healthy term live birth. CONCLUSION: Fetal SVT and hydrops fetalis are associated with significant perinatal morbidity and mortality. Resistance to intensive antiarrhythmic therapies may be augmented by the myocardial effects of obstetric cholestasis and remains a challenge for management. Copyright 2008 S. Karger AG, Basel.
OBJECTIVE:Supraventricular tachycardia (SVT) is the most common form of sustained fetal tachyarrhythmia in pregnancy. The development of hydrops with SVT is associated with significant worsening of prognosis. CASE: We report a case of fetal SVT with hydrops at 28 weeks' gestation that required both transplacental and direct fetal treatment in a woman with concurrent obstetric cholestasis. Antiarrhythmic therapy and control of the maternal liver function and bile acid levels with ursodeoxycholic acid was associated with a fetal response to treatment resulting in a healthy term live birth. CONCLUSION: Fetal SVT and hydrops fetalis are associated with significant perinatal morbidity and mortality. Resistance to intensive antiarrhythmic therapies may be augmented by the myocardial effects of obstetric cholestasis and remains a challenge for management. Copyright 2008 S. Karger AG, Basel.
Authors: Michele Miragoli; Siti H Sheikh Abdul Kadir; Mary N Sheppard; Nicoló Salvarani; Matilda Virta; Sarah Wells; Max J Lab; Viacheslav O Nikolaev; Alexey Moshkov; William M Hague; Stephan Rohr; Catherine Williamson; Julia Gorelik Journal: Hepatology Date: 2011-08-01 Impact factor: 17.425