Use of a subcutaneous beta-sympathomimetic pump for the treatment of fetal congenital complete heart block. A case report.
BACKGROUND
Complete heart block is the most common congenital heart block diagnosed in the fetalneonatal period. Maternal administration of beta-sympathomimetic agents has been used to treat this condition in the fetus. We know of no previous reports of the delivery of beta-sympathomimetics via a continuous subcutaneous pump for management of this condition.


METHODS
An intrauterine gestation at 28 5/7 weeks complicated by fetal congenital complete heart block was successfully managed to term with maternal administration of a beta-sympathomimetic agent via a continuous subcutaneous pump.


CONCLUSIONS
Maternal administration of beta-sympathomimetic agents by a continuous subcutaneous pump in cases of fetal congenital complete heart block may help prolong pregnancy by preventing hydrops fetalis and avoiding confounding problems of prematurity. However, it should be used with caution due to the potential for dilated cardiomyopathy in the infant.
Novi
Joseph M
JM
Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, 5 Penn Tower, 3400 Spruce Street, Philadelphia, PA 19104, USA. jnovi@obgyn.upenn.edu
Mulvihill
Beth H
BH
D000328:Adult; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D006327:Heart Block / Q000151:congenital* / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000196:embryology; D006801:Humans; D007231:Infant, Newborn; D015918:Infusion Pumps, Implantable; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D013566:Sympathomimetics / Q000008:administration & dosage*; D016216:Ultrasonography, Prenatal
D013566:Sympathomimetics