Pharmacological cardioversion of supraventricular tachycardia in pregnancy during continuous electrophysiological foetal monitoring: a case report

Abstract

Background Maternal tachycardia is the most frequently occurring cardiac complication during pregnancy. Often administration of drugs is required as a treatment. The drug of choice is intravenously administered adenosine because it is considered safe, though there are limited studies regarding safety for the foetus with the use of adenosine. Case summary We report a conversion of maternal atrio-ventricular (AV) nodal reentry tachycardia during pregnancy with the use of intravenous adenosine whilst continuous electrophysiological foetal monitoring. Four seconds after the maternal conversion, the foetal tracing suggests the presence of a ventricular extrasystole or a transient AV block. Discussion This case report illustrates that the administration of adenosine intravenously during pregnancy could have an effect on the foetal conduction system. Therefore, further investigation to assess the electrophysiological effect of adenosine on the foetal electrocardiogram seems required.

Risk stratification for maternal atrioventricular nodal re-entrant tachycardia during pregnancy: Case report and literature review

“…The final review consisted of 12 articles. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 There were 629 initial articles and 478 articles after placing English language and human species filters. The primary search yielded 5 articles.…”

“… 2 , 3 , 5 , 6 , 7 The secondary search produced 7 articles. 4 , 8 , 9 , 10 , 11 , 12 , 13 The final articles are listed in Table 1 , with the patient from this case report entered under article 13. There were 24 total patients.…”

“…Three articles, aside from this case report, described patients who underwent catheter ablation after delivery. 2 , 12 , 13 Tawam and colleagues 2 reported on 38 women that included 13 (34%) women with onset of SVT during pregnancy, 11 (29%) women with pre-existing SVT that was exacerbated by pregnancy, and others with no change in SVT symptoms through pregnancy. Of the 38 women, 8 were diagnosed with AVNRT by electrophysiology studies performed in the nongravid state.…”

“…Francinetti and colleagues 12 observed a pause in fetal heart rhythm on cardiotocography in a 30-year-old pregnant woman with a gestational age of 26 weeks and 3 days who received 6 mg of IV adenosine for SVT at 184 beats/min. Subsequently, she was discharged without additional medication.…”