Pharmacological transplacentalcardioversion with digoxin in ahydropic foetus: a case report

Cardioversión transplacentaria farmacológica con digoxina en feto hidrópico: reporte de caso.

Introduction: Fetal arrhythmias are conditions that occur in a small percentage of
pregnancies, diagnosed incidentally via ultrasound. Most arrhythmias are fetal tachyarrhythmias, which can complicate the course of pregnancy, causing fetal heart failure
and fetal hydrops in untreated cases and increasing rates of perinatal morbidity and
mortality. Case presentation: This is a 38-year-old patient, 27.6 weeks pregnant, who
was admitted to a tertiary care facility following the detection of foetal tachycardia during
an obstetric ultrasound scan. The foetal echocardiogram confirmed a tachyarrhythmia
of the supraventricular tachycardia type and foetal hydrops, the latter finding due to the
presence of ascites and pericardial effusion. Fetal structural anatomical pathology was
ruled out; laboratory tests performed on the patient ruled out Rh incompatibility, thyroid
disease and TORCH complex infections (toxoplasmosis, rubella, cytomegalovirus,
herpes, syphilis, hepatitis B and HIV). Subsequently, transplacental pharmacological
cardioversion with digoxin was performed, achieving a return to sinus rhythm and
resolution of the hydrops after three weeks of treatment. This allowed the pregnancy
to be carried to term at 37.0 weeks without any complications. Conclusion: Although
the incidence of foetal arrhythmias is low, timely and e y diagnosis and treatment in
institutions with trained staff can reduce perinatal complications and enable full-term
pregnancies. Furthermore, the efficacy of digoxin as an antiarrhythmic agent was