Fetal supraventricular tachycardia (SVT) has been found to have a prevalence ranging from 1/1,000 to 1/25,000 out of all the pregnancies. However, if left untreated, it could cause significant cardiac failure of the fetus, leading to fetal demise. Therefore, timely control of the fetal rhythm and its conversion to a normal sinus rhythm during the gestation period itself is highly essential. Antiarrhythmic agents via the transplacental route have been described as the mainstay for its rapid management. Hence, we present a case of transplacental antiarrhythmic treatment given for the management of fetal SVT detected at 22 weeks of pregnancy. The diagnosis of fetal arrhythmia in a 30-year-old pregnant woman was established following which IV Digoxin along with a second line agent flecainide was chosen and initiated immediately. Digoxin levels were maintained within the normal range of 1.31.5 ng/ml by appropriate dosage adjustment. This multidrug approach was found to be effective in restoring the fetal rhythm and the patient was discharged stably. The mother gave birth to a healthy female baby at 36 weeks of gestation.
Key words: supraventricular tachycardia, transplacental, antiarrhythmic, fetal rhythm, digoxin, flecainide
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