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- W4387260106 abstract "A 29-year-old primigravida was referred at 34 weeks with non-immune hydrops and placeta previa. We diagnosed fetal supraventricular tachycardia. Fetal heart rate was 273–- 300 beats per minute with 1:1 AV concordance, ascites, pleural effusion and subcutaneous edema (figure 1). Planning management was a dilemma as both satolol and flecainide were not available in town. After informed counselling of the family, we administered intramuscular digoxin in fetal buttock (0.8microgm/kg estimated fetal weight). Complete reversion to sinus rhythm happened within 3 hours of procedure. Patient was started on maternal oral transplacental therapy with digoxin after 48 hours and serum digoxin levels were maintained between 2-3ng/ml. Within 4 days, fetal ascites and subcutaneous edema resolved and pleural effusion reduced significantly. From 5th day post procedure, fetus developed paroxysms of SVT which increased progressively in number and time duration. Patient required two more doses of fetal intramuscular digoxin. Patient was delivered with Caesarean section at 36 weeks period of gestation. A 2.9 kg male baby was born. Heart rate at birth was normal. At the time of writing this manuscript, baby is day 8 of birth with normal cardiac rate and rhythm and has been discharged in stable condition. Direct fetal intramuscular injection of digoxin is indicated in resistant cases or where it may not be safe/feasible to administer antiarrhythmic drugs to mother. It can also be used to achieve rapid therapeutic levels in the fetus, especially in cases with hydrops. Repeated doses may be required. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article." @default.
- W4387260106 created "2023-10-03" @default.
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- W4387260106 date "2023-10-01" @default.
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- W4387260106 title "EP09.01: Fetal intramuscular digoxin administration for fetus with SVT and hydrops: a tale of multiple dilemmas and success" @default.
- W4387260106 doi "https://doi.org/10.1002/uog.26749" @default.
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