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Wang K, Xin J, Hu Q, Wang X, Yu H. Pregnancy outcomes in patients complicated with pre-excitation syndrome. Arch Gynecol Obstet 2024:10.1007/s00404-024-07420-6. [PMID: 38431699 DOI: 10.1007/s00404-024-07420-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Pregnant women with pre-excitation syndrome are more likely to develop supraventricular tachycardia (SVT) during pregnancy and delivery, leading to an increased risk of adverse events. METHOD This was a retrospective study of 309 pregnancies in 280 women (29 women had two pregnancies in this series) with pre-excitation syndrome who delivered at West China Second University Hospital from June 2011 to October 2021. All the 309 pregnant women with pre-excitation syndrome were divided into SVT and non-SVT groups to analyze the cardiac and obstetric complications. RESULTS Among the included pregnant women in the past 10 years, the prevalence of pre-excitation syndrome was 0.24% (309/127725). There were 309 cases with pre-excitation syndrome in all hospitalized pregnant women. Among them, 62 (20.1%, 62/309) had a history of SVT. In the 62 cases with SVT during pregnancy, 22 (35.5%) cases had a history of SVT. Gestational diabetes mellitus was associated with SVT during pregnancy. The cesarean section rate was 88.7% in the SVT group, which was significantly higher than that in the non-SVT group (64.8%) (P < 0.001). Cases with SVT during pregnancy had more cardiac and obstetric complications. Four fetal deaths were recorded in the SVT group. Additionally, 29 women experienced two pregnancies during the study period, among whom, five received radiofrequency ablation after the first delivery and obtained better outcomes in the second pregnancy. CONCLUSION The adverse outcomes such as cardiac complications, maternal and fetal complications (PROM, prematurity, SGA, fetal distress, etc.) in pregnant women with pre-excitation syndrome were closely related to SVT, with possible risk factors including history of SVT before pregnancy, cardiac function, heart organic abnormalities, and gestational diabetes mellitus.
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Affiliation(s)
- Kana Wang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, No. 20, 3rd Section, South Renmin Road, Chengdu, 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, No. 20, 3rd Section, South Renmin Road, Chengdu, 610041, China
| | - Junguo Xin
- School of Public Heath, Chengdu Medical College, No. 20, 3rd Section, South Renmin Road, Chengdu, 610041, China
| | - Qing Hu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, No. 20, 3rd Section, South Renmin Road, Chengdu, 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, No. 20, 3rd Section, South Renmin Road, Chengdu, 610041, China
| | - Xiaodong Wang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, No. 20, 3rd Section, South Renmin Road, Chengdu, 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, No. 20, 3rd Section, South Renmin Road, Chengdu, 610041, China
| | - Haiyan Yu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, No. 20, 3rd Section, South Renmin Road, Chengdu, 610041, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, No. 20, 3rd Section, South Renmin Road, Chengdu, 610041, China.
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Infraclavicular Brachial Plexus Block and Sugammadex Use in a Paediatric Patient with Wolff-Parkinson--White Syndrome. Rom J Anaesth Intensive Care 2020; 27:19-22. [PMID: 34056120 PMCID: PMC8158309 DOI: 10.2478/rjaic-2020-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Wolff–Parkinson–White (WPW) syndrome is a rare disease that can cause various patterns of tachyarrhythmias. The main goal of anaesthesiologists for the perioperative anaesthetic management of WPW patients must be to avoid sympathetic stimulation and prevent tachyarrhythmias. Case A 9-year-old male patient with a diagnosis of WPW syndrome, who underwent emergency surgery for supracondylar humerus fracture, is presented. General anaesthesia in combination with infraclavicular brachial plexus (ICBP) block was performed successfully without any complications. For the reversal of neuromuscular block, sugammadex was uneventfully used. Intraoperative sympathetic discharge due to surgical intervention was prevented with ICBP block. The ICBP block has also provided good postoperative analgesia. Conclusions Sugammadex is a good alternative for the reversal of neuromuscular blocks to avoid the undesirable effects of cholinergic drugs. Peripheral regional blocks that require relatively large doses of local anaesthetics can be safely performed with utmost attention in paediatric WPW patients.
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Amin HS. A young female patient with recurrent paroxysms of inappropriate sinus tachycardia. J Family Med Prim Care 2019; 8:3736-3738. [PMID: 31803681 PMCID: PMC6881912 DOI: 10.4103/jfmpc.jfmpc_793_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 09/22/2019] [Accepted: 09/30/2019] [Indexed: 11/04/2022] Open
Abstract
Tachycardia is one of the most common presentations in medical practice. In most cases, it could be attributed to emotional problems, anemia, or thyroid disorders. A 16-year-old female visited primary care clinics with the complaints of palpitation for years and initially diagnosed as a case of anxiety or stress. Her condition worsened and became more symptomatic over the last few months for which investigations were done. A provisional diagnosis of pre-excitation syndrome, Lown-Ganong-Syndrome, was made. This was based on short PR interval in ECG and an attack of supraventricular tachycardia and another attack of brief atrial fibrillation in addition to the family history of her mother of having pre-excitation abnormality. She was sent to electrophysiological study where no concealed accessory pathway was confirmed, and the diagnosis of inappropriate sinus tachycardia was the final diagnosis and medical treatment was initiated.
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Affiliation(s)
- Hussein S Amin
- Department of Family and Community Medicine, Chair of Medical Education Research and Development, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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