November 1, 1996American Journal of Perinatology
Fetal Supraventricular Tachycardia Complicated by Hydrops Fetalis: A Role for Direct Fetal Intramuscular Therapy
Why the study?
Does combined fetal intramuscular and maternal intravenous digoxin reduce the time to sinus rhythm in fetuses with SVT complicated by hydrops fetalis compared to maternal intravenous digoxin alone?
Population
8 pregnancies with hydropic fetuses having supraventricular tachycardia due to a reentrant mechanism, mean…
Comparison
Combined fetal intramuscular digoxin and… vs Transplacental therapy alone.
Design
Case_series
Authors
Discussion
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Implication
Caution against routine use in hydropic fetal SVT; leaves open combined FIM-MIV digoxin benefit pending controlled trials.
Structured PICO
Does combined fetal intramuscular and maternal intravenous digoxin reduce the time to sinus rhythm in fetuses with SVT complicated by hydrops fetalis compared to maternal intravenous digoxin alone?
P
Population
8 pregnancies with hydropic fetuses having supraventricular tachycardia (SVT) due to a reentrant mechanism, mean gestational age 29 +/- 4.8 weeks, mean heart rate 257 +/- 36 beats/minute.
I
Intervention
Combined fetal intramuscular (FIM) digoxin (88 micrograms/kg q 12-24 hours, maximum 3 injections) and maternal intravenous (MIV) digoxin.
C
Comparator
Transplacental therapy alone (maternal intravenous digoxin using standard loading and maintenance protocols, with additional maternal antiarrhythmic drugs as needed).
O
Outcome
Time to onset of the first two hours of sinus rhythm (TO2 degrees).surrogate
Direct fetal intramuscular injection of digoxin combined with transplacental therapy appears to substantially shorten the time to initial conversion of SVT and sustain sinus rhythm in fetuses with SVT complicated by hydrops fetalis.
Cite This Study
Parilla et al. (1996) studied this question.