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Indian Journal of Obstetrics and Gynecology

Volume  4, Issue 1, January - April 2016, Pages 57-61
 

Case Report

Digoxin Therapy for Fetal Supraventricular Tachycardia Diagnosed at 29 Weeks Gestation

Savita Bansal**, Pratibha Singh***

*Senior Resident, ***Additional Professor, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Jodhpur. **Consultant, Soni Manipal Hospital, Jaipur.

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DOI: DOI: https://dx.doi.org/10.21088/ijog.2321.1636.4116.11

Abstract

Fetal Supraventricular tachycardia (SVT), though rare, 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 [1]. Digoxin has been successfully used to treat fetal SVT, when therapy with digoxin fails alternative therapies may be used with equivocal results [2]. There is no clear consensus regarding the best drug-treatment regimens for fetal SVT. Digoxin has been recommended as first-line therapy in cases of SVT with cardiac failure, but recent evidence suggests that the transplacental passage may be impaired in the presence of hydrops [3]. Other agents such as flecainide and sotalol have been tried as first-line agents but with adverse events [4].

 We here describe a case of fetal supraventricular tachycardia without hydrops diagnosed antenatally at 29 weeks of gestationand managed with oral digoxin.


Corresponding Author : Nitisha Lath*