eISSN: 2449-6731
ISSN: 2449-6723
Prenatal Cardiology
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Review paper

Transplacental digoxin treatment in prenatal cardiac problems in singleton pregnancies - meta analysis (based on literature: 1992-2015)

Iwona Strzelecka
1, 2
Maria Respondek-Liberska
2, 3
Maciej Słodki
3, 4
Katarzyna Zych-Krekora
Bettina Cuneo

  1. Medical University of Lodz, Department of Embryology and Histology
  2. Department of Diagnoses and Prevention Fetal Malformations, Medical University of Lodz, Poland
  3. Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
  4. Faculty of Health Sciences. The State University of Applied Sciences in Plock, Poland
  5. Heart Institute, Department of Pediatrics Children’s Hospital Colorado and the University of Colorado School of Medicine, Aurora CO USA
Prenat Cardio 2016 Jan; 6(1):67-74
Online publish date: 2019/07/19
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Based on fourteen case reports from various centres from 1992–2015 and three original studies in 2006–2011, 122 fetuses were subjected to analysis. In these reports, transplacental digoxin treatment was administered to different cardiac anomalies such as SVT, Ebstein’s anomaly, critical AS , absent pulmonary valve syndrome, complete heart block, in foetuses with aneurysm/diverticulum of LV, in tricuspid atresia or dysplasia, rhabdomyoma, pulmonary atresia, HLHS with fibroelastosis, in TTTS and in extracardiac anomalies such as atriovenous malformation or sacrococcygeal teratoma. There was no statistical difference to suggest (Chi-square test) that digoxin was more efficient to control fetal arrhythmias than fetal congestive heart failure in nonarrhythmic patients. Conclusions: Foetal cardiac insufficiency may appear due to different reasons (in normal heart anatomy or in heart defects, in normal sinus rhythm or due to foetal arrhythmias: tachycardias or severe bradycardia) and may be a cause of intrauterine demise. So far, we do not have strong evidence that digoxin treatment may prevent foetal death or prematurity. More research is needed to ascertain if the prolonging of pregnancy resulted from digoxin treatment or if improvement in foetal circulatory insufficiency was influenced by spontaneous regression of foetal cardiac symptoms.

Digoxin, fetus treatment, cardiac arrhythmia, fetal oedema

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