i AM A 28 YEAR OLD FEMALE WITH 3 CHILDREN, I AM CURRENTLY PREGNANT WITH MY 4TH. i HAVE EXPERIENCED EPISODES OF SVT ABOUT ONCE A YEAR FOR 7 YEARS, IT SEEMS THAT DURING MY PREGNANCIES THEY HAPPEN MORE OFTEN. MY LAST EPISODE I WENT TO MY DOCTOR, WHO CALLED THE PARAMEDICS AND THEY ADMINISTERED THAT MEDICATION THAT SLOWS THE HEART IMMEDIATELY (CAN'T REMEMBER THE NAME) THE SECOND DOSE FINALLY BROUGHT IT DOWN FROM 210 TO 120 BPM. I HAD NEVER HAD TO HAVE IT BROUGHT DOWN THAT WAY, IT NORMALLY GOES AWAY ON ITS OWN. THERE WAS SOME TALK OF ABLATION A FEW YEARS BACK WHEN I WAS PREGNANT WITH MY LAST CHILD BUT THEY WANTED ME TO WAIT UNTIL I HAD MY BABY. I NEVER HAD THE PROCEDURE DONE. NOW IM PREGNANT AGAIN AND WONDERING WHAT TO DO, MY PRIMARY PHYSICIAN DOES NOT RECOMMEND MEDICATION. WILL SVT HARM MY BABY, AND IS THE DRUG THEY USED TO SLOW MY HEART DURING MY LAST EPISODE HARMFUL TO MY BABY. ALSO, CAN ABLATION BE DONE DURING PREGNANCY? THANK YOU FOR YOUR TIME. BETHANY
Firstly it is generally agreed upon that(most studies show) SVT is exacerbated
by pregnancy (that is to say that pregnancy increases the number of episodes as
well as the chance of developing SVT for the first time.) The SVT will not harm
the baby so long as it does not produce hypotension(low blood pressure) that
might starve the fetus of oxygen and nutrients. Because there are small but
potential risks to the health of the fetus with taking medications to control
the SVT, most intermittent episodes are not treated (self limited episodes that
start and stop on their own and do not produce low blood pressure), however if the
benefits of treatment outweigh the risks of the medication to the fetus, then the
first line agents are digoxin and propranolol(less than 160mg/day) in low doses.
These decisions should be made by you and your physicians as a team.
All drugs have a "pregnancy" class that correlates with risk and side effects,
this information can be found in the physicians' desk reference, or most easily
at your obstetrician's office where there is likely to be a reference on drug
safety in pregnancy. I can not of course comment on a drug that you are unaware
of the name as it could be anything, however I will reiterate that the first line
agents used to control SVT in pregnancy are digoxin and propranolol because there
is a lot of experience with these two in particular and of course without serious
side effects if used as directed.
Ablation during pregnancy is a very BIG "no no" since the procedure involves using
Flouroscopy (continuous X-ray) which puts the fetus/child at great risk for
congenital malformations in the early stages of pregnancy and at great risk for
cancers when performed in the later stages of the pregnancy. Good Luck.
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