scholarly journals Maternal monitoring and safety considerations during antiarrhythmic treatment for fetal supraventricular tachycardia

2018 ◽  
Vol 12 (2) ◽  
pp. 66-75 ◽  
Author(s):  
Isabelle Malhamé ◽  
Christy Gandhi ◽  
Gofran Tarabulsi ◽  
Matthew Esposito ◽  
Kristin Lombardi ◽  
...  
Keyword(s):  
Supraventricular Tachycardia ◽  
Adverse Reactions ◽  
Rare Complication ◽  
Maternal Monitoring ◽  
Fetal Tachyarrhythmia ◽  
Transplacental Therapy ◽  
Safety Considerations ◽  
Maternal Administration ◽  
Fetal Tachycardia ◽  
Antiarrhythmic Treatment

Fetal tachycardia is a rare complication during pregnancy. After exclusion of maternal and fetal conditions that can result in a secondary fetal tachycardia, supraventricular tachycardia is the most common cause of a primary sustained fetal tachyarrhythmia. In cases of sustained fetal supraventricular tachycardia, maternal administration of digoxin, flecainide, sotalol, and more rarely amiodarone, is considered. As these medications have the potential to cause significant adverse effects, we sought to examine maternal safety during transplacental treatment of fetal supraventricular tachycardia. In this narrative review we summarize the literature addressing pharmacologic properties, monitoring, and adverse reactions associated with medications most commonly prescribed for transplacental therapy of fetal supraventricular tachycardia. We also describe maternal monitoring practices and adverse events currently reported in the literature. In light of our findings, we provide clinicians with a suggested maternal monitoring protocol aimed at optimizing safety.

scholarly journals Case Series of Three Patients with Rifampicin-Induced Thrombocytopenia

2020 ◽  
Author(s):  
Chandramouli M.T
Keyword(s):  
Pulmonary Tuberculosis ◽  
Adverse Reactions ◽  
Rare Complication ◽  
Case Series ◽  
Tuberculosis Treatment ◽  
Effective Drug ◽  
Antitubercular Drugs ◽  
Short Course ◽  
Life Threatening

AbstractLife-threatening adverse reactions of antitubercular drugs are uncommon; however, thrombocytopenia is one such rare complication encountered with rifampicin, isoniazid, ethambutol, and pyrazinamide. Rifampicin is the most effective drug and its use in the tuberculosis treatment led to the emergence of modern and effective short-course regimens. I am reporting case series of three patients with pulmonary tuberculosis presented with rifampicin-induced thrombocytopenia.

scholarly journals Granulomatous Hepatitis Following Intra-Vesical Instillation of Bacillus Calmette–Guérin for Treatment of Bladder Cancer

2021 ◽  
Vol 13 (3) ◽  
pp. 611-618
Author(s):  
Elsa Alves Branco ◽  
Raquel Duro ◽  
Teresa Brito ◽  
António Sarmento
Keyword(s):  
Bladder Cancer ◽  
Hepatitis A ◽  
Adverse Reactions ◽  
Superficial Bladder Cancer ◽  
Rare Complication ◽  
Immunocompetent Patient ◽  
Clinical Suspicion ◽  
Bacillus Calmette Guerin ◽  
Granulomatous Hepatitis ◽  
Appropriate Treatment

Intra-vesical instillation of bacillus Calmette–Guérin (BCG) is an important treatment modality of superficial bladder cancer. It is usually well tolerated, although some adverse reactions can occur. One possible yet rare complication is granulomatous hepatitis, that is thought to be caused either by BCG infection or a hypersensitivity reaction to the bacillus. We present a case of a 79-year-old apparently immunocompetent patient who developed granulomatous hepatitis a few months after BCG administration for bladder cancer immunotherapy. It is important to notice that acid-fast smears and cultures are often negative, and these should not exclude diagnosis nor delay treatment. Our case highlights the importance of clinical suspicion and prompt initiation of appropriate treatment.

scholarly journals Drug Resistant Fetal Arrhythmia in Obstetric Cholestasis

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Nahide Altug ◽  
Ayse Kirbas ◽  
Korkut Daglar ◽  
Ebru Biberoglu ◽  
Dilek Uygur ◽  
...  
Keyword(s):  
Liver Disease ◽  
Bile Acid ◽  
Supraventricular Tachycardia ◽  
Preterm Labor ◽  
Fetal Distress ◽  
Intrauterine Death ◽  
Drug Resistant ◽  
Fetal Arrhythmia ◽  
Antiarrhythmic Treatment

Obstetric cholestasis (OC) is a pregnancy specific liver disease characterized by increased levels of bile acid (BA) and pruritus. Raised maternal BA levels could be associated with intrauterine death, fetal distress, and preterm labor and also alter the rate and rhythm of cardiomyocyte contraction and may cause fetal arrhythmic events. We report a case of drug resistant fetal supraventricular tachycardia and concomitant OC.Conclusion.If there are maternal OC and concomitant fetal arrhythmia, possibility of the resistance to antiarrhythmic treatment should be kept in mind.

scholarly journals Resolution of Fetal Hydrops Dependent on Sustained Fetal Supraventricular Tachycardia after Digoxin Therapy

Medicina ◽  
2020 ◽  
Vol 56 (5) ◽  
pp. 223
Author(s):  
Aureja Maciuleviciute ◽  
Migle Semenaite ◽  
Vladas Gintautas ◽  
Regina Maciuleviciene ◽  
Aras Puodziukynas ◽  
...  
Keyword(s):  
Heart Rate ◽  
Supraventricular Tachycardia ◽  
Fetal Heart Rate ◽  
Clinical Case ◽  
Fetal Heart ◽  
Caesarian Section ◽  
Fetal Hydrops ◽  
Maternal Administration ◽  
Special Case ◽  
Digoxin Therapy

We present a special case of fetal supraventricular tachycardia detected at 34 weeks gestation. Fetal hydrops was noted on ultrasound upon admission. Normal fetal heart rate was maintained for three weeks by maternal administration of digoxin. A live infant was delivered via caesarian section at 37 weeks gestation. This clinical case demonstrated that pharmacological treatment can be effective and helps to prolong pregnancy safely.

scholarly journals Fetal Tachycardia in the Delivery Room: Fetal Distress, Supraventricular Tachycardia, or Both?

2020 ◽  
Vol 10 (04) ◽  
pp. e380-e385
Author(s):  
Satvinder Singh Bhatia ◽  
Wendy H. Burgess ◽  
Jonathan R. Skinner
Keyword(s):  
Heart Rate ◽  
Differential Diagnosis ◽  
Supraventricular Tachycardia ◽  
Fetal Distress ◽  
Emergency Cesarean ◽  
Rapid Heart Rate ◽  
Life Threatening ◽  
Antenatal Detection ◽  
Fetal Arrhythmia ◽  
Fetal Tachycardia

Abstract Background Supraventricular tachycardia (SVT) is seldom considered a cause for fetal tachycardia; commoner etiologies including maternal fever and fetal distress are usually envisaged. Fetal arrhythmia can be missed as a diagnosis, potentially leading to suboptimal management. Cases Three cases are described where detection of fetal tachycardia >200 beats per minute (bpm) at 36, 40, and 38 weeks gestation resulted in emergency cesarean section for presumed fetal distress. Retrospective review of the cardiotocograph in two cases revealed baseline heart rates 120 to 160 bpm, with loss of trace associated with auscultated rates over 200 bpm. The diagnosis of SVT was not initially considered and made later when the infants required cardioversion at the age of 3 weeks, 2 days, and 8 days, respectively. The 36-week infant required noninvasive ventilation for prematurity. Conclusion SVT should be actively considered in the differential diagnosis of fetal tachycardia. Unrecognized fetal SVT may result in avoidable caesarean for suspected fetal distress, with potential prematurity-related problems. The cardiotocograph can be helpful if showing contact loss associated with rapid heart rate auscultation. The antenatal detection of fetal SVT is important as it can allow anticipation and prevention of neonatal SVT, which is potentially life-threatening if not detected and treated promptly.

Gemcitabine-Induced Supraventricular Tachycardia

2009 ◽  
Vol 95 (4) ◽  
pp. 547-549 ◽  
Author(s):  
Oshrat E Tayer-Shifman ◽  
Yakir Rottenberg ◽  
Mony Shuvy
Keyword(s):  
Heart Disease ◽  
Supraventricular Tachycardia ◽  
Cardiac Arrhythmia ◽  
Cardiac Toxicity ◽  
Rare Complication ◽  
Metastatic Breast ◽  
Common Side Effect ◽  
History Of ◽  
Oral Propranolol ◽  
Gemcitabine Treatment

The superior toxicity profile is one of the major reasons for the widespread use of gemcitabine in cancer treatment. Bone marrow suppression is the most common side effect, while non-hematological events are relatively infrequent. Cardiac toxicity is a rare complication and cardiac arrhythmia is even rarer. We report the case of a 67-year-old woman with metastatic breast cancer without a history of cardiac arrhythmia or ischemic heart disease who developed supraventricular tachycardia. The symptoms had started immediately after gemcitabine treatment. The arrhythmia responded poorly to common treatment and was eventually controlled by oral propranolol five days after admission. The present case suggests that supraventricular tachycardia may be triggered by gemcitabine even without underlying significant heart disease and may be resistant to conventional therapy.

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