Sustained Supraventricular Tachycardia While in Active Phase Labor

Supraventricular tachycardia (SVT) is one of the most common tachyarrhythmias found in young women, and SVT can be exacerbated by pregnancy. The symptoms associated with SVT frequently overlap with physiologic changes and symptoms of pregnancy which can lead to delayed or missed diagnosis.

We describe the presentation and the acute management of a patient who had sustained SVT that developed during the active phase of labor. We then detail the varying management approaches of SVT in pregnancy and labor as well as refractory management options. Maternal monitoring will also be discussed as this case shows how an SVT diagnosis could have been overlooked with varying maternal monitoring practices between or within facilities.When the patient went into SVT, the labor and delivery team was able to stabilize her, and she progressed to labor without further complications. Throughout the patient's remaining hospital admission, there was an additional episode of SVT, but this incident was also stabilized. The patient was stable for discharge on postpartum day 2 with follow-up recommended with cardiology.

Supraventricular tachycardias are often overlooked in young women and can present during labor. A lack of consensus amongst experts and medical organizations regarding management needs for further investigation.