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  1. Fulltext Intrauterine management of fetal supraventricular tachycardia (SVT) with cardiac failure
    Muniswaran G, Japaraj RP, Asri Ranga AR, Cheong HK
    Med J Malaysia, 2015 Dec;70(6):371-2.
    PMID: 26988216 MyJurnal
    Fetal arrhythmias are not uncommon in pregnancy. The diagnosis can be established on routine ultrasound scan. Fetal supraventricular tachycardia (SVT) is the most common cause of fetal tachycardia. If left undiagnosed and untreated, these fetuses may develop cardiac failure, hydrops fetalis and eventually death. We report two fetuses diagnosed antenatally to have fetal SVT. Both fetuses were in cardiac failure and were successfully treated with maternal administration of antiarrhythmic medications. Digoxin, and in severe instances, a combination with flecanaide significantly improved fetal outcomes and prevented fetal mortality. The long term prognosis of such patients are good.
  2. Fulltext COVID-19 preparedness-a survey among neonatal care providers in low- and middle-income countries
    Klingenberg C, Tembulkar SK, Lavizzari A, Roehr CC, Ehret DEY, Vain NE, et al.
    J Perinatol, 2021 05;41(5):988-997.
    PMID: 33850282 DOI: 10.1038/s41372-021-01019-4
    OBJECTIVE: To evaluate COVID-19 pandemic preparedness, available resources, and guidelines for neonatal care delivery among neonatal health care providers in low- and middle-income countries (LMICs) across all continents.

    STUDY DESIGN: Cross-sectional, web-based survey administered between May and June, 2020.

    RESULTS: Of 189 invited participants in 69 LMICs, we received 145 (77%) responses from 58 (84%) countries. The pandemic provides significant challenges to neonatal care, particularly in low-income countries. Respondents noted exacerbations of preexisting shortages in staffing, equipment, and isolation capabilities. In Sub-Saharan Africa, 9/35 (26%) respondents noted increased mortality in non-COVID-19-infected infants. Clinical practices on cord clamping, isolation, and breastfeeding varied widely, often not in line with World Health Organization guidelines. Most respondents noted family access restrictions, and limited shared decision-making.

    CONCLUSIONS: Many LMICs face an exacerbation of preexisting resource challenges for neonatal care during the pandemic. Variable approaches to care delivery and deviations from guidelines provide opportunities for international collaborative improvement.

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