Monochorionic Twin Pregnancy Complicated by Arrhythmia in One Twin: Longitudinal Hemodynamic Effects of Flecainide Cardioversion Assessed by Fetal Venous Doppler

Author:

Einum Anders12ORCID,von Brandis Philip3,Leirgul Elisabeth4ORCID,Ebbing Cathrine12

Affiliation:

1. Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway

2. Department of Clinical Science, University of Bergen, Bergen, Norway

3. Department of Obstetrics and Gynecology, Stavanger University Hospital, Bergen, Norway

4. Department of Cardiology, Haukeland University Hospital, Bergen, Norway

Abstract

AbstractA parous woman with a monochorionic twin pregnancy presented at gestational week 25 with an uncommon situation. One twin had developed hydrops, but not due to placental transfusion syndrome. The twin had a supraventricular tachyarrhythmia, a rare and severe complication that untreated would threaten the lives of both twins. We present the longitudinal Doppler ultrasound findings when assessing the hemodynamic effects of the arrhythmia and the transplacental treatment with antiarrhythmic medication (flecainide), and how the arrhythmia and the conversion to normal rhythm influenced umbilical and liver circulation in the fetus.

Publisher

Georg Thieme Verlag KG

Subject

General Medicine

Reference8 articles.

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2. Fetal supraventricular tachycardia. Review of the literature;M G Bergmans;Obstet Gynecol Surv,1985

3. Comparison of transplacental treatment of fetal supraventricular tachyarrhythmias with digoxin, flecainide, and sotalol: results of a nonrandomized multicenter study;E T Jaeggi;Circulation,2011

4. Fetal arrhythmia diagnosis and pharmacologic management;J F Strasburger;J Clin Pharmacol,2022

5. First-line antiarrhythmic transplacental treatment for fetal tachyarrhythmia: a systematic review and meta-analysis;T Alsaied;J Am Heart Assoc,2017

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