digoxin and Fetal-Growth-Retardation

Topics: Adrenergic beta-Antagonists; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Biotransformation; Coumarins; Digoxin; Drug Synergism; Female; Fetal Growth Retardation; Fetus; Heparin; Humans; Infant, Newborn; Milk, Human; Pacemaker, Artificial; Pregnancy; Pregnancy Complications, Cardiovascular; Procainamide; Quinidine; Verapamil

Between January 1991 and August 1992, 62 singleton pregnancies with heart disease were managed at the Wadia Maternity Hospital, Bombay. In 51 (82.3%), the heart disease was of rheumatic origin, while in 11 (17.7%), the disease was nonrheumatic. Thirteen cases of rheumatic disease (25.4%) were graded as Class III or IV, as per New York Heart Association (NYHA) classification. Six cases with rheumatic disease had closed mitral commisurotomy done, while none had a prosthetic heart valve. There was no maternal mortality. The average birth weight of neonates born to mothers with Class III or IV rheumatic heart disease was significantly lower (p < 0.05) than the average noted in singleton, normal, uncomplicated, non high risk pregnancies, during this period. There was also a significant difference (p < 0.05) in birth weight between infants born to mothers with NYHA Class I or II and Class III or IV symptoms. No infant had a congenital heart disease. Our findings suggest that though the presence of maternal heart disease did not affect the perinatal outcome, all infants born to mothers with NYHA Class III or IV had intrauterine growth retardation.

Topics: Adult; Digoxin; Embryonic and Fetal Development; Female; Fetal Growth Retardation; Furosemide; Gestational Age; Heart Diseases; Humans; Infant, Low Birth Weight; Infant, Newborn; Mothers; Potassium; Pregnancy; Severity of Illness Index

The expanded toxemia syndrome or gestosis refers to polysymptomatic diseases that are associated with pregnancy. This report discusses those cases without initial hypertension or proteinuria that were "cured" by delivery and were associated with maternal and fetal morbidity (usually intrauterine growth retardation). A list of suggested tests is presented to document gestosis in pregnant women with medical illnesses. Unlike preeclampsia, gestosis may occur at almost any time in pregnancy.

Topics: Chorionic Gonadotropin; Digoxin; Female; Fetal Growth Retardation; Humans; Hypertension; Placenta; Plasma Volume; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Cardiovascular; Regional Blood Flow; Syndrome

Fetal cardiac arrhythmias are usually first suspected on the basis of auscultatory findings during routine examination in pregnancy. With improved ultrasonic equipment a more accurate diagnosis of the type of arrhythmia can be made, associated problems such as structural cardiac defects and cardiac compromise can be recognized, and the effects of intrauterine treatment schedules can be closely monitored. The success of intrauterine therapy depends first and foremost on accurate intrauterine diagnosis. Until now intrauterine therapy for fetal cardiac arrhythmias has remained almost entirely restricted to pharmacological interventions.

Topics: Amiodarone; Arrhythmia, Sinus; Arrhythmias, Cardiac; Chromosome Aberrations; Chromosome Disorders; Diagnosis, Differential; Digoxin; Drug Therapy, Combination; Echocardiography; Edema, Cardiac; Female; Fetal Diseases; Fetal Growth Retardation; Fetal Heart; Gestational Age; Heart Rate; Humans; Karyotyping; Lung; Maternal-Fetal Exchange; Pregnancy; Procainamide; Prognosis; Propranolol; Quinidine; Ultrasonography; Vena Cava, Superior; Verapamil