Key result
Despite achieving target maternal serum digoxin concentrations, fetal heart rate did not improve, leading to discontinuation of digoxin and successful treatment with oral flecainide.
Why the study?
Fetal tachycardia is a rare disorder associated with significant fetal mortality, and digoxin is used for transplacental treatment, but data on therapeutic drug monitoring during therapy are limited.
Does therapeutic drug monitoring of transplacental digoxin help in decision-making for fetal tachyarrhythmia?
Population
A 40-year-old pregnant woman at 29 weeks of gestation with fetal tachycardia
Comparison
Transplacental intravenous digoxin therapy with therapeutic drug monitoring, later switched to oral flecainide
Design
Case report
Authors
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Digoxin monitoring may support timely flecainide switch in refractory fetal tachyarrhythmia; leaves open its routine decision-making value.
Case Report (n=1)
No
Does therapeutic drug monitoring of transplacental digoxin help in decision-making for fetal tachyarrhythmia?
Therapeutic drug monitoring of maternal digoxin levels can guide timely alternative treatment decisions when fetal tachyarrhythmia does not respond despite therapeutic serum concentrations.
Jeong et al. (2022) conducted a case report in Fetal tachyarrhythmia (n=1). Transplacental digoxin was evaluated on Fetal heart rate improvement. Despite achieving target maternal serum digoxin concentrations, fetal heart rate did not improve, leading to discontinuation of digoxin and successful treatment with oral flecainide.
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