To editor:The use of digoxin for the transplacental treatment of sustained fetal tachyarrhythmia(FT)was first reported in 1980.1 This medication is the first-line and most common antiarrhythmic in nonhydropic fetuses....To editor:The use of digoxin for the transplacental treatment of sustained fetal tachyarrhythmia(FT)was first reported in 1980.1 This medication is the first-line and most common antiarrhythmic in nonhydropic fetuses.Digoxin is administered to usually healthy mothers.Due to the intermediate solubility and low molecular weight of this drug,digoxin is readily delivered to the fetus via the placenta.The reported feto-maternal digoxin concentration ratio is 0.6–0.9 in normal pregnancies and lower in cases of hydrops fetalis(0.1–0.4)due to impaired transplacental transfer.2,3 Despite the long history of safe use in pregnancy,6%to 78%of patients have experienced digoxin side effects.4,5 Therefore,the maternal serum concentration of digoxin must be monitored to ensure drug safety and efficacy.Below is a case of FT treated using standard doses of digoxin and flecainide as adjunctive treatment.The patient experienced symptoms of digoxin toxicity,requiring dosage reduction.The patient gave her consent for the case to be reported.展开更多
文摘To editor:The use of digoxin for the transplacental treatment of sustained fetal tachyarrhythmia(FT)was first reported in 1980.1 This medication is the first-line and most common antiarrhythmic in nonhydropic fetuses.Digoxin is administered to usually healthy mothers.Due to the intermediate solubility and low molecular weight of this drug,digoxin is readily delivered to the fetus via the placenta.The reported feto-maternal digoxin concentration ratio is 0.6–0.9 in normal pregnancies and lower in cases of hydrops fetalis(0.1–0.4)due to impaired transplacental transfer.2,3 Despite the long history of safe use in pregnancy,6%to 78%of patients have experienced digoxin side effects.4,5 Therefore,the maternal serum concentration of digoxin must be monitored to ensure drug safety and efficacy.Below is a case of FT treated using standard doses of digoxin and flecainide as adjunctive treatment.The patient experienced symptoms of digoxin toxicity,requiring dosage reduction.The patient gave her consent for the case to be reported.
