scholarly journals Fetal supraventricular tachycardia at 12 weeks of gestation: diagnosis and follow up. A case report

2019 ◽  
Vol 21 (1) ◽  
pp. 93 ◽  
Author(s):  
Nathalie Jeanne Bravo-Valenzuela ◽  
Alberto Borges Peixoto ◽  
Edward Araujo Júnior ◽  
Gabriele Tonni
Keyword(s):  
Sinus Rhythm ◽  
Supraventricular Tachycardia ◽  
Fetal Heart ◽  
First Trimester ◽  
Ventricular Rate ◽  
Healthy Male ◽  
Fetal Hydrops ◽  
Male Baby ◽  
Digoxin Therapy

This report describes a case of fetal supraventricular tachycardia (SVT) diagnosed at 12 weeks of gestation in a pregnant woman with diabetes mellitus. Transplacental digoxin therapy administered orally to the mother was unsuccessful. Subsequently, sotalol was added to digoxin to achieve fetal heart rate (HR) control and the conversion to sinus rhythm was achieved. The fetal HR remained stable until term, and a healthy male baby was born. The newborn electrocardiogram showed sinus rhythm with normal PR and QTc intervals. When the newborn was stable, he was discharged with propanolol. Sustained SVT is extremely rare during the first trimester. The goal of treatment in utero is the conversion to sinus rhythm or reduction of the ventricular rate to tolerable levels, preventing or even reversing fetal hydrops.

scholarly journals Resolution of Fetal Hydrops Dependent on Sustained Fetal Supraventricular Tachycardia after Digoxin Therapy

Medicina ◽  
2020 ◽  
Vol 56 (5) ◽  
pp. 223
Author(s):  
Aureja Maciuleviciute ◽  
Migle Semenaite ◽  
Vladas Gintautas ◽  
Regina Maciuleviciene ◽  
Aras Puodziukynas ◽  
...  
Keyword(s):  
Heart Rate ◽  
Supraventricular Tachycardia ◽  
Fetal Heart Rate ◽  
Clinical Case ◽  
Fetal Heart ◽  
Caesarian Section ◽  
Fetal Hydrops ◽  
Maternal Administration ◽  
Special Case ◽  
Digoxin Therapy

We present a special case of fetal supraventricular tachycardia detected at 34 weeks gestation. Fetal hydrops was noted on ultrasound upon admission. Normal fetal heart rate was maintained for three weeks by maternal administration of digoxin. A live infant was delivered via caesarian section at 37 weeks gestation. This clinical case demonstrated that pharmacological treatment can be effective and helps to prolong pregnancy safely.

scholarly journals Atypical response of class IC atrial flutter to adenosine

2015 ◽  
Vol 76 (3) ◽  
Author(s):  
Francesco Rotondi ◽  
Tonino Lanzillo ◽  
Fiore Manganelli ◽  
Francesca Lanni ◽  
Ferdinando Alfano ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Atrial Flutter ◽  
Supraventricular Tachycardia ◽  
Ventricular Rate ◽  
Qrs Complex ◽  
Intravenous Amiodarone ◽  
Adenosine Administration ◽  
Ventricular Conduction

We report the case of a 67-year-old female with a wide QRS complex tachycardia at 180 bpm. A diagnosis of class IC atrial flutter with aberrant ventricular conduction caused by flecainide therapy was formulated. Intravenous adenosine administration resulted in adequate slowing of the ventricular rate and normalization of QRS complexes. Restoration of sinus rhythm was achieved with intravenous amiodarone. The response to adenosine confirmed the diagnosis of supraventricular tachycardia with aberrant conduction, but the transition from arrhythmia onset to restoration of sinus rhythm showed interesting peculiarities.

Fetal hydrops due to a tachyarrhythmia progressing to organic pulmonary stenosis

2000 ◽  
Vol 10 (2) ◽  
pp. 158-161 ◽  
Author(s):  
V. Fesslova ◽  
L. Villa ◽  
U. Nicolini
Keyword(s):  
Sinus Rhythm ◽  
Right Ventricular ◽  
Supraventricular Tachycardia ◽  
Pulmonary Stenosis ◽  
Cardiac Anatomy ◽  
Fetal Hydrops ◽  
Premature Rupture ◽  
Female Baby

AbstractWe discovered supraventricular tachycardia with advanced hydrops in the setting of normal cardiac anatomy at 26 weeks of gestation which resolved successfully following administration of digoxin and flecainide to the mother. A female baby was born after a premature rupture of the membranes at 30.6 weeks. The neonate was in sinus rhythm, showed a progressive regression of right ventricular insufficiency, but developed signs of acquired pulmonary valvar and subvalvar stenosis at 2 months of age.

scholarly journals Extended multi-drug maternal therapy for refractory supraventricular tachycardia in premature hydrops fetalis

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Fathima Minisha ◽  
Melissa Deniz ◽  
Sawsan AlObaidly ◽  
Reema Kamal
Keyword(s):  
Drug Therapy ◽  
Supraventricular Tachycardia ◽  
Tertiary Care ◽  
In Utero ◽  
Care Hospital ◽  
Fetal Hydrops ◽  
Extended Duration ◽  
Maternal Tolerance ◽  
Fetal Response

Abstract Background Fetal supraventricular tachycardia (SVT) is a reversible cause of fetal hydrops, with better outcomes if detected early and reverted in utero. Modern imaging allows accurate diagnosis and maternal anti-arrhythmic therapy can be practiced ensuring in utero cardioversion. Case presentation We present a case of preterm fetal hydrops due to SVT successfully reverted in utero by multidrug maternal therapy. The mother presented to our tertiary care hospital at 32 weeks’ gestation with a fetal heart rate of 229 beats/min with evidence of mild fetal pericardial effusion and ascites. Under strict maternal monitoring, the treatment was started with parenteral digoxin. Flecainide, sotalol and amiodarone were introduced sequentially based on the response until cardioversion was achieved at 35 weeks with no maternal side effects. She labored spontaneously and delivered a 2.6 kg baby boy 4 days after the successful cardioversion. The baby was discharged home on day 7 on oral amiodarone with outpatient follow-up. Digoxin monotherapy failed in our case, possibly due to evidence of hydrops and a sequential multi-drug therapy was required for an extended duration of up to 2 weeks to achieve cardioversion successfully. Conclusions Our report suggests that multi-drug therapy is more successful in cases of SVT with fetal hydrops, titrated according to fetal response and maternal tolerance, although a prolonged period of therapy might be required to achieve the desired clinical effect.

Prediction of Digoxin Treatment Failure in Infants with Supraventricular Tachycardia: Role of Transesophageal Pacing

PEDIATRICS ◽  
1985 ◽  
Vol 75 (2) ◽  
pp. 288-293
Author(s):  
D. Woodrow Benson ◽  
Ann Dunnigan ◽  
David G. Benditt ◽  
Theodore R. Thompson ◽  
Athi Narayan ◽  
...  
Keyword(s):  
Drug Treatment ◽  
Treatment Failure ◽  
Supraventricular Tachycardia ◽  
Cycle Length ◽  
Chronic Treatment ◽  
Atrial Pacing ◽  
Clinically Significant ◽  
Digoxin Therapy

Transesophageal atrial pacing was used to initiate and terminate tachycardia in 24 infants (seven female and 17 male, aged 1 to 34 days) with ECG documentation of supraventricular tachycardia. Six infants received no chronic treatment, and chronic oral digoxin prophylaxis was administered to 18 infants in an effort to prevent recurrences of tachycardia. In these 18 infants, the effectiveness of digoxin therapy in preventing the initiation of tachycardia by transesophageal pacing was compared with its ability to prevent spontaneous recurrences of supraventricular tachycardia. While receiving chronic oral digoxin therapy, tachycardia could be reinitiated in 15/18 (83%) infants. In these infants, the cycle length of tachycardia and the atrioventricular interval were the same before and during chronic digoxin treatment. Three infants in whom tachycardia could not be initiated during chronic digoxin therapy had no spontaneous recurrences during 6 months of follow-up, whereas 10/15 (67%) infants in whom tachycardia could be reinitiated had clinically significant recurrences in spite of chronic digoxin therapy. Six infants who received no chronic drug treatment had no documented recurrences during 6 months of follow-up. This study demonstrates that digoxin was effective in preventing significant spontaneous recurrences of supraventricular tachycardia in only 8/18 (44%) infants treated with digoxin. The ability to initiate supraventricular tachycardia with transesophageal pacing may be useful in determining which digoxin-treated infants are at risk for recurrence. Finally, not all infants with supraventricular tachycardia require chronic prophylaxis; six of the untreated infants had no documented recurrences.

scholarly journals Instantly Converting Atrial Fibrillation into Sinus Rhythm by a Digital Rectal Exam on a 29-year-Old Male

2010 ◽  
Vol 3 ◽  
pp. 117954761000300
Author(s):  
Cheng-Huai Ruan
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Supraventricular Tachycardia ◽  
Vagal Tone ◽  
Risk Profile ◽  
Electrical Cardioversion ◽  
Digital Rectal Exam

Vagal maneuvers cause increase in vagal tone, which has been shown to slow many types supraventricular tachycardia, such as atrial fibrillation (AF). However, the conversion of AF to sinus rhythm is usually not associated with vagal manuvers. Thus, AF is classically treated with medication and electrical cardioversion. Here, we present a 29-year-old male with no cardiovascular history and a low atherosclerotic risk profile who developed AF which converted into sinus rhythm immediately after a digital rectal exam. The patient remained asymptomatic after a 3-month follow-up. This implies that the digital rectal exam can be considered as an additional attempt to convert AF to sinus rhythm in AF patients.

Evaluation of Normal Heart Rate in Early Pregnancy Corresponding to Gestational Age between Six to Eight Weeks

Med Phoenix ◽  
2017 ◽  
Vol 2 (1) ◽  
pp. 34-37
Author(s):  
Akhilesh Kumar Jha ◽  
Bikranta Rimal ◽  
Tarannum Khatun
Keyword(s):  
Heart Rate ◽  
Early Pregnancy ◽  
Well Being ◽  
Clinical Decision ◽  
First Trimester ◽  
Normal Heart ◽  
Normal Heart Rate ◽  
First Trimester Of Pregnancy ◽  
Singleton Pregnancies

Background: Ultrasonography is the reliable and safe way for the evaluation of pregnancy. Heart rate can be detected more confidently from the Ultrasonography. Heart rate is an important parameter for the evaluation of early pregnancy. The purpose of this study was to evaluate the normal heart rate in embryos/fetuses between 6 and 8 weeks of gestation.Method: In our region people are poor and most of them do not know the benefit of regular follow up examination during pregnancy. So most of pregnant women come to our centre at late stage of pregnancy. The number of pregnancy cases is good in our centre but the number of early pregnancy cases coming to regular follow up examination is low. Thus the study was conducted in 51 normal singleton pregnancies undergoing routine ultrasound examination during the first trimester of pregnancy. The duration of study was 6 weeks.Result: Out of 51 singleton pregnancies, 20 cases (39.2%) heart rate were between 131-150 beat per minute and 25 cases (49.0 %) heart rate were between 151-170 beat per minute. However 4 cases (7.8%) were between 110-120 beat per minute and 2 cases (3.9%) were more than 171 beat per minute. There were zero cases above the 180 beat per minute.Conclusion: The result of this study will help to evaluate abnormal and normal fetal heart rate so that early clinical decision whether to continue the pregnancy or terminate it can be taken, as Ultrasonography is only the method used in screening fetal well being in most of the region of our country.Med Phoenix Vol.2(1) July 2017, 34-37

scholarly journals Identifying Patterns of Symptom Distress in Pregnant Women: A Pilot Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6333
Author(s):  
Ching-Fang Lee ◽  
Fur-Hsing Wen ◽  
Yvonne Hsiung ◽  
Jian-Pei Huang ◽  
Chun-Wei Chang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Healthcare Providers ◽  
First Trimester ◽  
Symptom Distress ◽  
Teaching Hospitals ◽  
Lower Back ◽  
Distress Symptoms ◽  
Related Symptom ◽  
Experienced Symptom

During pregnancy, a woman’s enlarged uterus and the developing fetus lead to symptom distress; in turn, physical and psychological aspects of symptom distress are often associated with adverse prenatal and birth outcomes. This study aimed to identify the trends in the trajectory of these symptoms. This longitudinal study recruited 95 pregnant women, with a mean age of 32 years, from the prenatal wards of two teaching hospitals in northern Taiwan. Symptom distress was measured by a 22-item scale related to pregnancy-induced symptoms. The follow-up measurements began during the first trimester and were taken every two to four weeks until childbirth. More than half of the pregnant women experienced symptom distress manifested in a pattern depicted to be “Decreased then Increased” (56.8%). Other noticeable patterns were “Continuously Increased” (28.4%), “Increased then Decreased” (10.5%) and “Continuously Decreased” (4.2%), respectively. It is worth noting that most pregnant women recorded a transit and increase in their symptom distress, revealed by their total scores, at the second trimester (mean 22.02 weeks) of pregnancy. The participants’ major pregnancy-related distress symptoms were physical and included fatigue, frequent urination, lower back pain, and difficulty sleeping. The mean scores for individual symptoms ranged from 2.32 to 3.61 and were below the “moderately distressful” level. This study provides evidence that could be used to predict women’s pregnancy-related symptom distress and help healthcare providers implement timely interventions to improve prenatal care.

scholarly journals Maternal and Fetal Outcomes in Women with Brain Arteriovenous Malformation Rupture during Pregnancy

2021 ◽  
pp. 1-7
Author(s):  
Kimberly L. Yan ◽  
Nerissa U. Ko ◽  
Steven W. Hetts ◽  
Shantel Weinsheimer ◽  
Adib A. Abla ◽  
...  
Keyword(s):  
San Francisco ◽  
Treatment Strategies ◽  
First Trimester ◽  
Interventional Treatment ◽  
Maternal Outcomes ◽  
Fetal Outcomes ◽  
Brain Avm ◽  
Risk Of Hemorrhage ◽  
The University

Background: Sporadic brain arteriovenous malformations (BAVM) are a major cause of hemorrhagic stroke in younger persons. Prior studies have reported contradictory results regarding the risk of hemorrhage during pregnancy, and there are no standard guidelines for the management of pregnant women who present with BAVM rupture. The purpose of this study is to describe maternal and fetal outcomes and treatment strategies in patients with BAVM hemorrhage during pregnancy. Methods: We performed a retrospective review of the University of California, San Francisco Brain AVM Project database for female patients who were pregnant at the time of BAVM hemorrhage between 2000 and 2017. Clinical and angiographic characteristics at presentation, BAVM treatment, and maternal outcomes using modified Rankin scale (mRS) score at presentation and 2-year follow-up were recorded. Fetal outcomes were abstracted from medical records and maternal reports. Results: Sixteen patients presented with BAVM hemorrhage during pregnancy, 81% (n = 13) of whom were in their second or third trimester. Three patients (19%) who were in their first trimester terminated or miscarried pregnancy prior to BAVM intervention. Of the remaining 13 patients, 77% (n = 10) received emergent BAVM treatment at time of hemorrhage prior to delivery, and 85% of patients achieved BAVM obliteration and good maternal outcomes (mRS 0–2) at 2-year follow-up. All patients had uncomplicated deliveries (69% cesarean and 23% vaginal) with no reports of postnatal cognitive or developmental delays in infants at 2-year follow-up. Conclusions: Our study shows good long-term maternal and fetal outcomes in ruptured BAVM patients presenting during pregnancy, the majority who received BAVM interventional treatment prior to delivery.

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