title: A case study of a pregnant patient with a congenital heart block accompanied by left isomerism and uncontrolled type 2 diabetes who was treated successfully with ritodrine.
abstract: We present a case study of a patient with a congenital heart block associated with a left isomerism that was diagnosed during the 26th week of gestation. The mother had type 2 diabetes mellitus that was difficult to control during the early stages of the pregnancy. A fetal echocardiogram revealed an atrioventricular dissociation, with an atrial rate of 120 bpm and a ventricular rate of 55 bpm. Subsequent examinations also revealed a left isomerism in the fetus. To increase the fetal heart rate, a continuous intravenous infusion of ritodrine was administered. The fetal ventricular rate rapidly increased to 65 bpm. The pregnancy successfully continued until term and a female infant weighing 3,182 g was born via a cesarean section. A subsequent surgery was performed to provide the infant with a permanent cardiac pacemaker, and notably, the child is now 4 months of age and her growth has been within the normal range.
authors.affiliation: Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, Japan. takehiro-s@med.niigata-u.ac.jp
authors.forename: Takehiro
authors.initials: T
authors.lastname: Serikawa
authors.forename: Kaya
authors.initials: K
authors.lastname: Ichikawa
authors.forename: Akira
authors.initials: A
authors.lastname: Kikuchi
authors.forename: Koichi
authors.initials: K
authors.lastname: Takakuwa
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005315:Fetal Diseases / Q000188:drug therapy*; D006327:Heart Block / Q000151:congenital / Q000175:diagnosis / Q000188:drug therapy*; D006340:Heart Rate, Fetal / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D012312:Ritodrine / Q000008:administration & dosage*
chemical_list: D000318:Adrenergic beta-Agonists; D012312:Ritodrine