EP14.07: Peripartal management of fetal LQTS with polymorphic arrhythmias: high‐dose magnesium therapy, ß‐blocker and vaginal delivery

Peripartal management of a fetal LQTS and initiation of a vaginal birth. Case report with interesting echo findings (A-MM, C-TDI) of a symptomatic fetal LQTS under discussion of current management recommendations in the literature. 29-year-old gravida I with maternal LQTS 2 intake in the 35th WG with fetal sinus bradycardia and polymorphic tachyarrhythmias: VES, SVES, SVT, bigeminus and short torsades (M-mode and colour-TDI). Under high dose magnesium therapy (average level: 1.51 mmol/l) arrhythmia frequencies could be significantly reduced. Daily US controls showed a normal growth. Vaginal delivery under magnesium therapy with CTG monitoring was possible: vacuum extraction in the 41st WG due to suspicious CTG (3225 g, APGAR 9/10/10, BE -7.4 mmol/l, pH 7.20) neonatal: QTc 620 ms (LQTS), postpartum therapy with propranolol 3mg/kg/d. Elective sections from 35 WG pregnancy are described and recommended in the literature. We describe a successful magnesium therapy in symptomatic fetal LQTS and successful Cytotec initiation with possible CTG monitoring. To our knowledge, this is the initial description of vaginal delivery under magnesium therapy in symptomatic fetal LQTS. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.