The resolution of fetal hydrops using combined maternal digoxin and dexamethasone therapy in a case of isolated complete heart block at 30 weeks gestation.
The development of hydrops fetalis in cases of isolated complete heart block is associated with a very poor prognosis. Various pharmacological strategies have been proposed, involving both direct fetal access and transplacental therapy, with inconsistent results in small numbers of subjects. The optimal antenatal management will remain uncertain until multicentre controlled trials are organised. We report the complete resolution of fetal hydrops at 30 weeks of gestation using combination of maternal digoxin and dexamethasone therapy, despite persistence of the complete heart block. A Caesarean section was performed at 37 weeks of gestation due to evidence of fetal intrauterine growth restriction. The baby girl is now 8 months of age and remains well, with a heart rate of 45-50 beats per minute on no medication and without pacing.
Brackley
K J
KJ
Department of Fetal Medicine, Birmingham Women's Hospital, Birmingham, UK.
Ismail
K M
KM
Wright
J G
JG
Kilby
M D
MD
D000328:Adult; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D004077:Digoxin / Q000008:administration & dosage*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006327:Heart Block / Q000150:complications / Q000188:drug therapy*; D006340:Heart Rate, Fetal / Q000187:drug effects; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D016216:Ultrasonography, Prenatal
D002316:Cardiotonic Agents; D005938:Glucocorticoids; D004077:Digoxin; D003907:Dexamethasone