[Congenital atrial flutter with hydrops fetalis caused by tocolytic therapy (author's transl)].
A 31-year-old healthy woman received Ritodrine (Pre-Par) from the 26th week of gestation because of twin pregnancy. Three weeks before birth continous intravenous medication with the same drug was commenced because of premature uterine contractions. Five days later a heart rate of over 200/minute was noted in one of the twins. This tachycardia persisted until birth while the heart rate of the other twin remained normal. At 33 weeks monozygotic female twins were delivered after artifical rupture of membranes. One twin was normal, birth weight 1.6 kg. The other baby showed persistent atrial flutter, was hydropic (weight 2.75 kg) and suffered from gross cardiac failure. Atrial flutter was converted to sinus rhythm one hour after birth by DC-countershock. Digoxin was commenced, the child rapidly improved and now still remains in sinus rhythm six month later.
D001282:Atrial Flutter / Q000139:chemically induced*; D004071:Digitalis Glycosides / Q000627:therapeutic use; D004200:Diseases in Twins / Q000139:chemically induced; D004487:Edema / Q000139:chemically induced; D005260:Female; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange; D007752:Obstetric Labor, Premature / Q000517:prevention & control; D011247:Pregnancy; D011295:Prenatal Care; D011412:Propanolamines / Q000009:adverse effects*; D012312:Ritodrine / Q000009:adverse effects*; D014427:Twins
D004071:Digitalis Glycosides; D011412:Propanolamines; D012312:Ritodrine
Kongenitales Vorhofflattern mit Hydrops fetalis durch mütterliche Tokolytikamedikation.