What question did this study set out to answer?

To evaluate the efficacy and feasibility of direct ultrasound-guided intraperitoneal antiarrhythmic drug administration in hydropic fetuses with tachyarrhythmias refractory to maternal transplacental therapy.

January 1, 1988Journal of Perinatal MedicineOpen Access

Intrauterine therapy of fetal tachyarrhythmias: Intraperitoneal administration of antiarrhythmic drugs to the fetus in fetal tachyarrhythmias with severe hydrops fetalis

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Why the study?

Does direct intraperitoneal administration of antiarrhythmic drugs improve rhythm control in fetuses with tachyarrhythmia and severe hydrops fetalis?

Population

n=2 fetuses with fetal tachyarrhythmia and congestive heart failure accompanied by signs of non-immune…

Design

Case_series

Authors

UGU. GembruchPediatric / Congenital Cardiology MHM. HansmannUniversity of Bonn DRDirk A. RedelUniversity of Bonn

Discussion

Member takes

Implication

May support intraperitoneal antiarrhythmics as rescue in refractory fetal tachyarrhythmia with hydrops; hypothesis-generating and requires prospective validation.

Key Points

To evaluate the efficacy and feasibility of direct ultrasound-guided intraperitoneal antiarrhythmic drug administration in hydropic fetuses with tachyarrhythmias refractory to maternal transplacental therapy.
Treated two hydropic fetuses presenting with congestive heart failure and tachyarrhythmias refractory to standard transplacental pharmacotherapy.
Administered antiarrhythmic agents (beta-methyldigoxin, verapamil, or propafenon) at intravascular dosages directly into fetal ascites under continuous ultrasound guidance (12 interventions in case 1, 2 interventions in case 2).
Cardioversion from supraventricular tachycardia or 2:1 atrioventricular conduction block to sustained sinus rhythm was successfully achieved within 5 to 15 minutes of injection in both fetuses.
Intraperitoneal injection achieved rapid therapeutic drug concentrations directly in the fetus, effectively bypassing the impaired placental drug transfer caused by non-immune hydrops fetalis.

Structured PICO

Does direct intraperitoneal administration of antiarrhythmic drugs improve rhythm control in fetuses with tachyarrhythmia and severe hydrops fetalis?

Population

n=2 fetuses with fetal tachyarrhythmia and congestive heart failure accompanied by signs of non-immune hydrops fetalis.

Intervention

Direct intraperitoneal administration of antiarrhythmic drugs (beta-methyldigoxin, verapamil, propafenon) to the fetus using ultrasound guidance, supplementing high-dose transplacental therapy.

Outcome

Cardioversion to sinus rhythm or improved AV conductionsurrogate

Direct intraperitoneal administration of antiarrhythmic drugs to the fetus may be an effective supplemental therapy for fetal tachyarrhythmia with severe hydrops fetalis when transplacental therapy fails.

Cite This Study

Gembruch et al. (1988) studied this question.

synapsesocial.com/papers/6a79c6cdfbd9051d3b0df19d https://doi.org/10.1515/jpme.1988.16.1.39

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Implication

May support intraperitoneal antiarrhythmics as rescue in refractory fetal tachyarrhythmia with hydrops; hypothesis-generating and requires prospective validation.

Intrauterine therapy of fetal tachyarrhythmias: Intraperitoneal administration of antiarrhythmic drugs to the fetus in fetal tachyarrhythmias with severe hydrops fetalis

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Intrauterine therapy of fetal tachyarrhythmias: Intraperitoneal administration of antiarrhythmic drugs to the fetus in fetal tachyarrhythmias with severe hydrops fetalis

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider