[Fetal supraventricular tachycardia. Prenatal treatment with a digoxin-amiodarone combination]. 1987

N Vlahot, and J Morvan, and A M Bernard, and J P Cleophax, and J Firmin

The authors present a case history of supra-ventricular tachycardia (SVT) diagnosed in a fetus after 32 weeks of amenorrhoea in a 2-para woman of 29 years. This SVT was discovered after an urgent consultation had been asked for when uterine contractions started after the uterus had been over-distended. The diagnosis that had been suspected when it had been impossible to measure the fetal heart rate by a monitor was confirmed when the rate was found to be 270 beats per minute using TM ultrasound. A complete detailed ultrasound examination showed that there was generalised oedema (anasarca). Searching for a congenital malformation revealed none. Other tests eliminated other causes for the anasarca. Treatment was rapidly instituted by injecting 2 and later 3 ampoules of 0.25 mg of Digoxin in 24 hours. This did not change the fetal heart rate although continued for five days. Adding Amiodarone into a transfusion at the rate of 3 ampoules in 24 hours slowed the fetal heart rate to 220 beats per minute within 24 hours. After 3 days treatment with Amiodarone the heart rate went into sinusal rhythm. A boy weighing 3,410 g was delivered by caesarean section 3 days later after the membranes had ruptured prematurely. The placenta weighed 1,750 g. The newborn infant was transferred into a special care baby unit where it progressed favourably. The child left the unit after six weeks on treatment with Digoxin. Consulting the literature has shown under what circumstances the condition can arise and the ways of diagnosing it and the differential diagnosis of fetal SVT, as well as methods of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D004077 Digoxin A cardiotonic glycoside obtained mainly from Digitalis lanata; it consists of three sugars and the aglycone DIGOXIGENIN. Digoxin has positive inotropic and negative chronotropic activity. It is used to control ventricular rate in ATRIAL FIBRILLATION and in the management of congestive heart failure with atrial fibrillation. Its use in congestive heart failure and sinus rhythm is less certain. The margin between toxic and therapeutic doses is small. (From Martindale, The Extra Pharmacopoeia, 30th ed, p666) Digacin,Digitek,Digoregen,Digoxina Boehringer,Digoxine Nativelle,Dilanacin,Hemigoxine Nativelle,Lanacordin,Lanicor,Lanoxicaps,Lanoxin,Lanoxin-PG,Lenoxin,Mapluxin,Boehringer, Digoxina,Lanoxin PG,Nativelle, Digoxine,Nativelle, Hemigoxine
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D005260 Female Females
D005315 Fetal Diseases Pathophysiological conditions of the FETUS in the UTERUS. Some fetal diseases may be treated with FETAL THERAPIES. Embryopathies,Disease, Fetal,Diseases, Fetal,Embryopathy,Fetal Disease
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000638 Amiodarone An antianginal and class III antiarrhythmic drug. It increases the duration of ventricular and atrial muscle action by inhibiting POTASSIUM CHANNELS and VOLTAGE-GATED SODIUM CHANNELS. There is a resulting decrease in heart rate and in vascular resistance. Amiobeta,Amiodarex,Amiodarona,Amiodarone Hydrochloride,Amiohexal,Aratac,Braxan,Corbionax,Cordarex,Cordarone,Kordaron,L-3428,Ortacrone,Rytmarone,SKF 33134-A,Tachydaron,Trangorex,Hydrochloride, Amiodarone,L 3428,L3428,SKF 33134 A,SKF 33134A
D013617 Tachycardia, Supraventricular A generic expression for any tachycardia that originates above the BUNDLE OF HIS. Supraventricular Tachycardia,Supraventricular Tachycardias,Tachycardias, Supraventricular

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