Why the study?
Supraventricular tachyarrhythmia with hydrops in one twin of a monochorionic pregnancy is a rare and severe complication that threatens the lives of both fetuses.
Transplacental flecainide successfully treated fetal supraventricular tachyarrhythmia and hydrops in a monochorionic twin without adverse hemodynamic effects on the unaffected twin.
Case illustrates Doppler monitoring of transplacental antiarrhythmic therapy in monochorionic twins; leaves open optimal protocols and generalizability.
A parous woman with a monochorionic twin pregnancy presented at gestational week 25 with an uncommon situation. One twin had developed hydrops, but not due to placental transfusion syndrome. The twin had a supraventricular tachyarrhythmia, a rare and severe complication that untreated would threaten the lives of both twins. We present the longitudinal Doppler ultrasound findings when assessing the hemodynamic effects of the arrhythmia and the transplacental treatment with antiarrhythmic medication (flecainide), and how the arrhythmia and the conversion to normal rhythm influenced umbilical and liver circulation in the fetus.
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Einum et al. (2023) studied this question.
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