Key result
Maternal betamimetics linked to reversible fetal and neonatal arrhythmias in twin pregnancies.
Why the study?
There are no published data about fetal arrhythmia in multiple pregnancies despite many publications on fetal arrhythmia in singletons.
Case Report (n=4)
Detection of fetal arrhythmia in multiple pregnancies warrants early referral to a tertiary center for comprehensive management of the mother, fetus, and neonate.
Potential arrhythmia risk with betamimetics in twins merits monitoring; leaves open causality and generalizability.
There are a lot of publications about fetal arrhythmia in singletons, but up to now there are no published data about fetal arrhythmia in multiple pregnancies. In the present study a case history of fetal and neonatal arrhythmia in one of twins from two mothers treated with betamimetic agents due to imminent preterm labor is reported and discussed. A first case with fetal bradycardia due to complete A-V block had congenital cordis abnormalities (VSD and PFO). The second case with prenatal detected extrasystoles had normal heart anatomy. Digoxin was administered to the mother, in the aim to treat fetal arrhythmia without success, because the baby had postnatal bradycardia. After hospitalisation in Cardiology Department the described cases were successfully treated. In both cases the second twins were without neonatal arrhythmia and with no structural heart abnormalities. We summarise that in situation of detection fetal arrhythmia the complexity of the problems experienced may warrant early referral to a tertiary centre where the overall management of the mother, fetus and neonate, may be undertaken.
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Czeszyńska et al. (1998) conducted a case report in Fetal and neonatal arrhythmia in twin pregnancy (n=4). Betamimetic agents (fenoterol) vs. Unaffected twin (internal comparison) was evaluated on Development of fetal and neonatal arrhythmia. In two twin pregnancies where mothers were treated with betamimetics for preterm labor, one twin in each pair developed fetal and neonatal arrhythmia that resolved with postnatal management.
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