什么是最佳的digoxin水平? 胎儿心房的治疗在单桃体双胞胎中具有挑战性的案例
Soo Jung Kim1, Hee Do Jeon2, So-Yeon Shim3
1Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea.
Medicina (Kaunas, Lithuania)
|July 29, 2023
概括
这项案例研究表明,更高的狄戈辛水平可以有效地治疗双胞胎怀孕的单胆双胞胎 (MCDA) 胎儿心房动. 由于这些怀孕中独特的循环因素,这种方法可能是必要的.
科学领域:
- 心脏病学 心脏病学
- 新生儿科学 新生儿科学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 心房动是一种罕见但严重的胎儿心律失常.
- 迪戈辛是胎儿心房的第一线治疗方法,但最佳血清水平仍在争论中.
- 标准毒素目标水平 (1.0-2.0 ng/mL) 基于潜在的毒性问题.
研究的目的:
- 报告一个胎儿心房的情况,在一个单牙双胞胎 (MCDA) 怀孕.
- 为了评估高于标准的狄戈辛标位水平对管理这种疾病的有效性.
主要方法:
- 一个31+3周怀孕的MCDA双胞胎怀孕的案例介绍,双胞胎A的胎儿心房动.
- 管理涉及向高于通常推的血清狄戈辛水平.
- 胎儿心声扫描用于监测心率.
主要成果:
- 通过使用超过标准目标范围的狄戈辛水平,成功控制了胎儿心房动.
- 患有心房的胎儿 (双胞胎A) 最初显示心房率为214bpm.
- 双胞胎B没有异常发现.
结论:
- 在MCDA双胞胎怀孕中,胎儿心房的成功鼻转化可能需要更高的血清狄戈辛标水平.
- 在MCDA怀孕中,母亲和胎儿的独特循环特征可能会影响狄戈辛的疗效.
- 这一案例表明,可能需要根据特定的怀孕类型来个性化滴毒素标水平.
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